Health Insurance Uptake and Affordability of Care Among Patients with Hypertension in a Federal Teaching Hospital in Southwestern Nigeria

Abstract

This study aims to assess health insurance uptake and affordability of care among patients with hypertension in a Federal Teaching Hospital in Southwestern Nigeria. This was a cross sectional study involving 138 hypertensive patient selected through systematic random sampling technique from the cardiology clinic of a Federal Teaching Hospital. A semi-structured, interviewer administered questionnaire was used to collect data. Analysis was done using Statistical Package for Social Sciences (SPSS) version 21. A significance level of 5% was used. The mean age (standard deviation) of the patients was 57.4 (12.8) years with median (interquartile range) monthly income of ₦46,500.00 (₦55,000.00) [US$129 (US$152.78)]. The health insurance uptake among them was 26.8%. Out of those who had no health insurance cover, 87.2% of them believed it could make their financial burden less and wish to be registered. Hypertensive patients enrolled under health insurance were significantly less likely to face financial difficulty when paying for drugs (p<0.001) and investigations (p<0.001). Additionally, these patients were significantly less likely to deny or defer project(s) in order to pay for their illness (p=0.004) and to have their source of livelihood being negatively affected by this illness (p=0.002). This study found a low health insurance uptake among hypertensive patients, even though most of the patients who had no health insurance cover were ready to enroll. Additionally, health insurance was identified to promote affordability of care among these patients. It is therefore crucial to put in place measures that will increase health insurance coverage among these patients.

Households Health Care Financing Methods: Social Status Differences, Economic Implications and Clinical Outcomes Among Patients Admitted in a Pediatric Emergency Unit of a Tertiary Hospital in South West Nigeria

“…One of the factors that have been found to affect enrollment into community and private health insurance schemes is poor awareness. 12,37,38 In this study the awareness rate of health insurance was low and is comparable to findings by Ipinnimo et al 29…”

“…36 One of the factors that have been found to affect enrollment into community and private health insurance schemes is poor awareness. 12,37,38 In this study the awareness rate of health insurance was low and is comparable to findings by Ipinnimo et al 29 The current study also showed that high level of paternal education; parental occupational status and the overall social status of the household are all factors that are associated with health care financing method of the household, such that more household with high paternal educational levels, civil servants and higher social status had health insurance. Similar findings were reported in other studies.…”

“…4 In the current study, nearly 90% of the households financed emergency services for their wards via OOP. This is comparable to reports of studies by Ipinnimo et al 29 in 2021, World Bank in 2018, 30 Ogaji et al 31 in 2015 and Olatunya et al 32 in 2015. To reduce burden of OOPP, Nigeria had enacted health insurance schemes in 1999 and fully launched it in 2005.…”

“…[43][44][45][46][47] The fall out of catastrophic expenditure often include stopping children from going to school, diverting their children's school fees to offset health service bills, loss of job or means of livelihood among others. 29 These are potentially impoverishing effects of household financing their health OOP. These effects are made worse by the fact that majority of people in Nigeria are already living in poverty or are on the verge of poverty.…”

The Unspotted Impact of Global Inflation and Economic Crisis on The Nigerian Healthcare System

“…[6] Also, the majority of the people pay for healthcare out-of-pocket with <5% of the population being captured under the National Health Insurance Scheme. [7] The inflation in healthcare is more of cost-push inflation (from increase in the cost of production) and to some extent build-in inflation (expectations that inflation will continue leading to wages increase). [1] The rise in the cost of health care services and other products has led to the decrease healthcare seeking behavior of the populace, especially those without health insurance cover, consequently, leading to delay elective care.…”