Process evaluation of temporary exemption implementation for emergency cases in St. Augustine Muheza designated district hospital
Date
2019
Authors
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Journal ISSN
Volume Title
Publisher
Mzumbe University
Abstract
This study was set to evaluate temporary exemption implementation for emergency cases at St. Augustine Muheza designated district hospital. A temporary exemption is the process in which patients who have no money for covering health services at the point of service delivery, after being assessed by a social welfare officer, have a chance of receiving services under loan agreement so that such money to be settled on later. The main purpose is to ensure accessibility to health services regardless of the ability to pay. The general objective of the study was to evaluate temporary exemption implementation for eligible emergency cases and its effect on sustainability in revenue collection. The study was meant to answer the following research questions: How is the guideline for cost-sharing policy in the area of temporary exemption to emergency cases are being implemented at St. Augustine Muheza designated district hospital?; How the follow-ups of un-paid bills from patients who received temporary exemptions are being conducted?; How verification of payments which have done by clients who were given temporary exemptions, and are already at their homes are conducted? and; What are the factors facilitating or impinging the payment of bills by temporarily exempted patients at St. Augustine Muheza hospital? The study applied a descriptive cross-sectional design, in which participants were selected through purposive and convenient sampling techniques. Documentary review, in-depth interviews and focus group discussions were used for data collection. A total of 34 respondents participated in the study whereby 8 health workers involved in one FGD, and the rest 26 (both health workers and community members) participated in the in-depth interviews. The content analysis method was used to analyse data from field. The overall results revealed that about 2% of the total patients admitted at St. Augustine Muheza designated District hospital per year received temporary exemptions, and for three consecutive years only 3.5 out of 94.6 million were paid as temporary exemption bills. The low payment of bills was due to the lack of follow up strategies at the hospital, absence of social welfare department and lack of community sensitization. This study documented that, St. Augustine Muheza designated district hospital have no mechanisms for bills payment, lack of social welfare officers, and lack of community sensitization are some of the factors influencing the low payment of bills that led the hospital to operate under budgets.
Description
A dissertation Submitted to School of Public Administration and Management of Mzumbe University in partial fulfillment of Requirements for the Award of Masters of Science Degree in Health Monitoring and Evaluation of Mzumbe University.
Keywords
Emergency Cases, Temporary Exemption, Health Facilities, Patients under Emergency Care, Cost-sharing policy, Cross-sectional design, Bills payment-health services
Citation
APA