Magnitude and Associated Factors of Out-of-Pocket Healthcare Expenditure among Outpatients Visiting Public Hospitals in Jigjiga Town, Somali Region, Eastern Ethiopia

Background: Out-of-pocket healthcare expenditure (OOPHE) remains a major challenge to accessing adequate medical service, often discouraging individuals from seeking necessary medical services. The extent of OOPHE in Jigjiga city is unknown. This study aimed to assess the magnitude and associated factors of OOPHE among outpatients visiting public hospitals in Jigjiga city, Somali region, Eastern Ethiopia. Methods: A hospital-based cross-sectional study was conducted among 406 outpatients selected through systematic random sampling from three public hospitals in Jigjiga city. Data were collected through interviews-administered questionnaires and analysed by SPSS version 25.0. Binary and multivariable logistic regression analyses were performed to identify factors associated with OOPHE among outpatients (p < 0.05). Results: Overall, 89.5% of respondents incurred out-of-pocket healthcare payments at the point of service delivery. The mean OOPHE per outpatient was 485.6 {+/-} 349 birr ($3.12 {+/-} $2.24). Female [AOR = 3.38, 95% CI (1.54-7.42)], unmarried [AOR = 5.32, 95% CI (1.77-16.03)], and traveled [&ge;]5 km [AOR = 7.07, 95% CI (1.46-34.29)] and higher educational attainment (college and above) [AOR = 7.07, 95% CI (1.55-32.28)] were independently associated with higher odds of incurred OOPHE. Conclusion: The magnitude of out-of-pocket healthcare payments among outpatients was high. Sex, marital status, educational level, and distance to reach a public health facility were significant predictors of OOPHE. Policy action to reduce OOPHE in this setting should include strengthening and expanding the Community-Based Health Insurance scheme and promoting prepayment mechanisms, such as Social Health Insurance, for formal sector employees, specifically for government employees.