Abstract:
Background: - A growing literatures on health care demand has pointed out that individuals are not
passive recipients of health services; rather they make active choices about whether or not to make use of
health services provided. The choice of a healthcare facility is not as straight forward as it usually seems.
The assumption is that patients want high-quality care at the cheapest rates and choose centers that best fit
their needs and preferences.
Objective: - To assess level of choice for public or private healthcare providing facility and associated
factors among government employees in Nekemte town, 2015.
Method: - The study was conducted in Nekemte town, which is located 334km to the west of Addis
Ababa. Institution based cross-sectional study design was used. A simple random sampling technique
was employed to select study participants and data were collected using a semi-structured interviewer
administered questionnaire. Logistic regressions models were fit to determine presence of statistically
significant association between independent variables and the outcome variable at P value < 0.05 and OR
with 95% CI.
Results: - Three hundred fourty-six government employees participated in the study which yield
response rate of 95.8%. Government healthcare facilities were preferred by 57.2% of the study
participants while the remaining 42.8% were chosen private facilities. Reasons for choice of
public facilities were cost of health services and availability qualified personnel’s. While for
those participants who chosen private facilities were availability qualified personnel’s and short
waiting time. In this study factors associated with the choice of usual healthcare providing
facilities were include good patient-provider interaction (AOR=3.19, 95%CI: 1.87, 5.43), good
cleanliness of facility (AOR=1.84, 95%CI: 1.12, 3.03), satisfaction (AOR=2.30, 95%CI: 1.33,
3.98) and healthcare expenditure of individuals (AOR=1.98, 95%CI: 1.14, 3.44).
Conclusion: - More than half of government employees were chose public health facility as their
usual health care provider. However, there is a room for quality improvement in the public health
facilities especially on patient-provider interaction, cleanliness of facility and satisfaction of
consumers. Therefore, this finding has important policy implication since changes in cost of
health service and perceived quality would mean changes in client satisfaction as well as their
choice
