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Incidence of Catastrophic Health Expenditures Amongst Hospitalized Neonates in Ekiti, Southwest Nigeria
Ezra O Ogundare1,2, Adekunle B Taiwo3, Oladele S Olatunya1,2
1Department of Paediatrics, Ekiti State University, Ado-Ekiti, Nigeria.
Insights
Neonatal illnesses in Nigeria lead to catastrophic health spending for families, with 81.5% exceeding 10% of their income on medical bills. This highlights the urgent need for improved healthcare financing and insurance coverage.
Area of Science:
- Public Health
- Health Economics
- Neonatal Medicine
Background:
- Neonatal illnesses incur substantial costs, often leading to prolonged hospital stays.
- Families, particularly those below the poverty line, bear the brunt of these expenses, risking catastrophic health spending.
- Current healthcare financing models are insufficient to protect vulnerable households from severe financial distress due to neonatal care costs.
Purpose of the Study:
- To determine the average cost of managing common neonatal illnesses in Ekiti State, Nigeria.
- To assess the financial burden these illnesses place on families in the region.
- To identify the prevalence of catastrophic health spending among families with neonates.
Main Methods:
- A cross-sectional study was conducted at Ekiti State University Teaching Hospital, focusing on neonates admitted to the Special Care Baby Unit (SCBU).
- Data on monthly family income, out-of-pocket expenditures for drugs, laboratory tests, and hospital bills were collected using a structured questionnaire.
- Catastrophic health spending (CHS) was defined as healthcare expenditures exceeding 10% of the overall family income.
Main Results:
- Out-of-pocket payments covered medical bills for 95% of the 119 neonates studied.
- A significant 81.5% of families experienced catastrophic health spending (CHS), exceeding 10% of their monthly income.
- The median total expenditure was N24,500.00, with prematurity treatment being the most expensive. A strong positive correlation was found between hospital stay duration and total hospital bills (r = 0.576, P < 0.001).
Conclusions:
- Neonatal illnesses pose a significant risk of catastrophic health spending for many households in the studied region.
- There is a critical need for increased government investment in healthcare infrastructure and services.
- Expanding health insurance coverage to all citizens is essential to mitigate the financial burden of neonatal care.
Background:
Neonatal illnesses require huge spending due to prolonged hospital stay. The management of these illnesses is usually financed by individual families which in most instances are living below the poverty line. This healthcare financing method can readily push families into catastrophic spending on health.
Aim:
To ascertain the average cost of managing common neonatal illnesses and the financial burden, it constitutes to families in Ekiti State, southwest Nigeria.
Methods:
We conducted a cross-sectional study on the out-of-pocket spending involved in managing neonates admitted into and discharged from the SCBU of the Ekiti State University Teaching Hospital, Ado-Ekiti, southwest Nigeria. Data collected included the monthly family income, the money spent on drugs, laboratory investigations and the hospital bill using a purposely designed structured questionnaire. Healthcare spending greater than 10% of the overall family income was described as catastrophic health spending (CHS).
Results:
The medical bills for most (95%) of the 119 study participants were paid through the out-of-pocket means and 81.5% of the families spent more than 10% of their monthly earnings (CHS) to settle medical bills. Close to 50% of the families belonged to the lower social economic class. The median (IQR) duration of hospital stay was 2.75 days (3.0-8.0). The median (IQR) total expenditure was N24,500.00 (N13,615.00-N41,487.50). The median (IQR) expenditure for the treatment of prematurity was highest at N55,075.00 (USD 133.10) [N27,350.00 (USD 66.10)-N105,737.50 (USD 255.53)] and more than 60.5% of the expenses was on hospital utilities and consumables. The length of hospital stay showed a robust positive correlation with the total hospital bill (r = 0.576, P < 0.001).
Conclusion:
Neonatal illnesses put many households at risk of catastrophic health spending. There is need for increased government investment in health and extension of the health insurance scheme to all the citizens of the country.
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