An Evaluation of the Outcomes of Mutual Health Organizations in Benin 英文参考文献.docVIP

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An Evaluation of the Outcomes of Mutual Health Organizations in Benin 英文参考文献.doc

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An Evaluation of the Outcomes of Mutual Health Organizations in Benin 英文参考文献

AnEvaluationoftheOutcomesofMutualHealth OrganizationsinBenin SlimHaddad1*,ValeryRidde1,IsmaelouYacoubou2,Genevie`veMa′k1,MichelGbetie′3 1ResearchCentreoftheUniversityofMontrealHospitalDepartmentofSocialandPreventiveMedicine,FacultyofMedicine,UniversityofMontreal,Quebec,Canada, 2Centred’e′tudes etd’appuitechniqueauxinstitutionsdemicroassurancesante′,Parakou,Benin,3CentreNationalHospitalieretUniversitairedeCotonou,Cotonou, Benin Abstract Background:Mutualhealthorganizations(MHO)havebeenseenasapromisingalternativetothefee-basedfundingmodel butscientificfoundationstosupporttheirgeneralizationarestilllimited.Verylittleisknownabouttheextentoftheimpact ofMHOsonhealth-seekingbehaviours,qualityandcosts. Methodology/PrincipalFindings:Wepresenttheresultsofanevaluationoftheeffectsattributabletomembershipinan MHOinaruralregionofBenin.Twoprospectivestudiesofusers(parturientsandhospitalizedpatients)wereconductedon theterritoryofaninter-mutualconsistingof10MHOsandasmanyhealthcarecentres(one,Ouesse′,servingasareferral hospital)andonehospital(Papane′).Membersandnon-memberswerematched(142pairsofparturientsand109triadsof hospitalized patients) and multilevel multiple regression was used. Results show that member parturients went to healthcare centres sooner (p=0.049) and were discharged more quickly after delivery (p=0.001) than non-members. Length of stay in some cases was longer for hospitalized member parturients (+41%). Being a member did not shorten hospitalstay,totallengthofepisodeofcare,ortimebetweenappearanceofsymptomsandrecoursetocare.Regarding expenses,memberparturientspaidone-thirdlessthannon-membersforadelivery.Forhospitalizedpatients,theaverage savingsformemberswasaround$35US.TotalexpensesincurredbypatientshospitalizedatPapane′ Hospitalwerehigher thanatOuesse′ butthetwohospitals’relativeadvantageswerecomparableat236%and239%,respectively. Conclusion/Significance: These results confirm mutual health organizations’ capacity to protect households financially, even if