Abstract
This study aimed to assess patients’ experiences on using non-contracted private hospitals and applying for eligibility under the Universal Coverage for Emergency Patients (UCEP). A telephone survey was conducted by using a semi-structured questionnaire. Populations were beneficiaries of three public health insurance schemes, Universal Coverage Scheme (UCS), Civil Servant Medical Benefit Scheme (CSMBS) and Social Security Scheme (SSS) who used non-contracted private hospitals and applying for eligibility through the Emergency Pre-Authorization program (PA) during July–October 2017. A simple random sampling was employed with an equal quota of samples for each scheme in each month for calling. Samples of the study included 212 and 210 cases who were receiving the call and willing to provide information out of 393 and 405 or 54 and 52 percent of calls made for those who met and did not meet the criteria of critical emergency respectively. Data analysis was done by using SPSSpc version 18 and weighted according to actual proportion of each scheme users was applied. Results show that the Universal Coverage for Emergency Patients (UCEP) was quite successful in the implementation. Patients with critical emergency conditions increased in access to financial protection under the program. Convenience in transportation to the hospital and being trust in regular hospital were two main reasons of getting emergency care from the private hospitals. Those with non-critical emergency conditions were more likely to choose their regular hospital than those with critical emergency conditions. The program could protect eligible patients quite well from financial risk during the critical period or the first 72 hours of admission; however, more than half of those with non-critical emergency conditions spent out of their own pocket to cover the cost of care. Furthermore, strengthening of enforcement process of the Sanatorium Act is needed to prevent patients with emergency conditions from being asking for payments prior to provision of services or during the critical period in addition to strengthening of public relations on channel for making complaints.
