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Table 4 Univariate logistic regression analysis including the association of independent variables with the likelihood of incurring excessive out-of-pocket expenditure (OOPs) for outpatient care

From: Assessing out-of-pocket expenditures for primary health care: how responsive is the Democratic Republic of Congo health system to providing financial risk protection?

Determinant % (n) of the determinants Rate of high OOPs in subgroups (%) Crude OR [95% CI] P-value Pearson Chi2
Wealth quintile      < 0.001***
 Poorest 23.80 (67,911) 18.10 1   
 Poorer 19.50 (55,595) 17.80 1.28 [0.76–2.17] 0.356ns  
 Middle 18.70 (53,245) 16.40 1.21 [0.65–2.28] 0.546ns  
 Wealthier 17.60 (50,255) 15.00 1.16 [0.58–2.32] 0.666ns  
 Wealthiest 20.30 (57,793) 32.60 3.12 [1.82–5.37] < 0.001***  
Highest education of household head      0.776ns
 None 13.40 (38,038) 13.90 1.06 [0.58–1.95] 0.849ns  
 Primary 24.80 (70,631) 23.20 0.91 [0.6–1.4] 0.682ns  
 Secondary 57.30 (163,166) 57.20 1   
 Tertiary 4.50 (12,754) 5.60 1.41 [0.71–2.83] 0.326ns  
Owns a means of transportation      0.882ns
 No 62.10 (176,942) 62.60 1   
 Yes 37.90 (107,878) 37.40 0.97 [0.67–1.41] 0.882ns  
Large household size (≥6)      0.056ns
 No 63.10 (179,630) 56.20 1   
 Yes 36.90 (105,191) 43.80 1.51 [0.99–2.31] 0.057ns  
Province       < 0.001***
 Equateur 14.40 (40,978) 9.30 0.28 [0.14–0.56] < 0.001***  
 Kasaï Occidental and Oriental 56.30 (160,426) 45.70 0.38 [0.18–0.8] 0.011*  
 Maniema /Orientale 29.30 (83,416) 45.00 1   
Gender      0.281ns
 Female 54.70 (153,660) 56.70 1   
 Male 45.30 (127,359) 43.30 0.89 [0.72–1.1] 0.281ns  
Head of household      0.622ns
 No 87.30 (248,701) 86.30 1   
 Yes 12.70 (36,120) 13.70 1.14 [0.67–1.93] 0.622ns  
Under 5 years old      0.016*
 No 64.30 (183,075) 70.50 1   
 Yes 35.70 (101,746) 29.50 0.67 [0.49–0.93] 0.016*  
50+ years old      0.058ns
 No 84.70 (241,380) 81.50 1   
 Yes 15.30 (43,441) 18.50 1.40 [0.99–1.99] 0.058ns  
Number of days lost to illness      0.023*
 Zero 28.50 (19,973) 23.90 1   
 Less than a week 27.10 (20,074) 24.00 1.08 [0.61–1.91] 0.785ns  
 A week to less than a month 38.00 (34,494) 41.20 1.44 [0.95–2.16] 0.084ns  
 One month or above 6.40 (9196) 11.00 3.14 [1.46–6.76] 0.004**  
Sector of health facility      0.004**
 Public sector 61.90 (176,059) 71.60 1   
 Private sector 26.60 (75,737) 23.80 0.69 [0.4–1.19] 0.182ns  
 Informal sector 11.50 (32,843) 4.70 0.26 [0.15–0.46] < 0.001***  
Total number of paid visits, mean (SE) 1.18 (0.02) 1.69 1.13 [0.96–1.33] 0.131ns 0.131ns
Share of OOP on drugs, mean (SE) 0.82 (0.02) 0.75 0.24 [0.08–0.67] 0.007** 0.002**
Health insurance status      0.577ns
 Uncovered 98.97 (3251) 98.90 1   
 Covered 1.03 (34) 1.10 0.80 [0.36–1.78] 0.577ns  
HF has functional X-rays      0.004**
 No 99.90 (284,563) 99.90 1   
 Yes 0.10 (257) 0.10 1.85 [1.21–2.83] 0.005**  
HF has functional ultrasound      0.036*
 No 98.70 (281,249) 97.70 1   
 Yes 1.30 (3571) 2.30 2.91 [1.02–8.29] 0.045*  
HF has functional microscopes      0.495ns
 No 51.10 (145,409) 47.30 1   
 Yes 48.90 (139,411) 52.70 1.24 [0.67–2.29] 0.495ns  
HF has functional sterilizers   0.306ns
 No 52.50 (149,396) 46.90 1   
 Yes 47.50 (135,425) 53.10 1.37 [0.75–2.52] 0.307ns  
HF has functional centrifuges   0.135ns
 No 81.30 (231,472) 87.30 1   
 Yes 18.70 (53,349) 12.70 0.54 [0.24–1.22] 0.139ns  
HF avg. price for care services, mean (SE) 5.00 (1.12) 7.72 1.01 [1–1.02] 0.188ns 0.188ns
Long travel time (30+ min)   0.006**
 No 16.40 (46,632) 8.50 1   
 Yes 83.60 (238,188) 91.50 2.64 [1.29–5.4] 0.008**  
HF level 1: Health center   0.357ns
 No 41.80 (119,096) 38.30 1   
 Yes 58.20 (165,543) 61.70 1.23 [0.79–1.93] 0.357ns  
HF level 2: General reference hospital   < 0.001***  
 No 95.80 (272,754) 89.40 1   
 Yes 4.20 (11,884) 10.60 7.73 [3.78–15.78] < 0.001***  
Dissatisfaction index score   0.696ns
 No dissatisfaction 17.90 (50,927) 15.00 0.81 [0.28–2.3] 0.686ns  
 Score 1 Low dissatisfaction 23.10 (65,925) 22.60 0.99 [0.37–2.65] 0.979ns  
 Score 2 23.20 (65,980) 27.40 1.31 [0.51–3.4] 0.573ns  
 Score 3 16.30 (46,520) 16.70 1.05 [0.31–3.58] 0.934ns  
 Score 4 12.10 (34,555) 11.10 0.91 [0.3–2.69] 0.858ns  
 Score 5 High dissatisfaction 7.30 (20,914) 7.20 1   
  1. Statistical significance of *: 0.01 ≤ p < 0.05; **: 0.001 ≤ p < 0.01; ***: p < 0.001; ns: p ≥ 0.05
  2. All estimates are weighted
  3. HF health facility