Satisfaction and associated factors among users of the community-based health insurance program in public health institutions of Addis Ababa, Ethiopia: A cross-sectional study, 2022

Objective Community-based health insurance is an evolving concept for providing financial security against the cost of health care for low-income households. It is used as one tool to achieve universal health coverage. Quality of care and client satisfaction is a big issue in the implementation of community-based health insurance programs in the health care system. This study aimed to assess the level of satisfaction and its associated factors among users of the community-based health insurance program in Addis Ababa, Ethiopia. Method A cross-sectional study was executed in ten public health institutions selected by the lottery method. The study participant was selected using a systematic sampling method after proportional allocation. A structured interview questionnaire was used to collect the data. Participant satisfaction was measured using a five-point Likert scale with 10 items. Descriptive statistics, bivariate, and multivariate logistic regression analysis were computed for predictor variables. In bivariate analysis, variables with a P value of ≤ 0.25 were included in the multivariate regression model. The adjusted odd ratio (AOR) was used to determine predictor variables with 95% CI, and the P-value < 0.05 was considered significant. Result In the study, 382 study participants were included with a response rate of 100%. The overall satisfaction level was 50.8%. Availability of drug (AOR=3.63, CI: 1.51–8.74), facility service-related processes (AOR=2.23, CI: 1.34-3.69), and service provider friendliness (AOR=3.42, CI: 2.10-5.56) were significantly associated predictors of satisfaction level at (P<0.05). Conclusion The overall satisfaction level is still not satisfactory. Community-based health insurance users’ dissatisfaction is associated with facility service availability and service providing compassionate care. Therefore, health institutions should work on the availability of medications in stock, facility service processes, and service providers’ compassionate and respectful care to enhance the satisfaction of their scheme users.