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Payment Methods and Coping Strategies for Health Care Costs by Patients with Chronic Diseases in a Low-Middle Income
U I Mariere1, D S Ogaji2, O O Obikeze3
1Health Insurance Programmes, Federal Medical Centre, Yenagoa, Bayelsa State.
Insights
Patients with chronic diseases often pay out-of-pocket for healthcare, even with insurance. This leads to difficult coping strategies, highlighting the need for better financial protection programs for managing chronic conditions.
Area of Science:
- Public Health
- Health Economics
- Chronic Disease Management
Background:
- Chronic diseases represent a significant global health burden, necessitating sustained healthcare access.
- Understanding patient financial strategies for managing chronic conditions is crucial for effective healthcare policy.
Purpose of the Study:
- To identify payment methods for healthcare costs among patients with chronic diseases.
- To explore coping strategies employed by these patients to manage healthcare expenditures.
- To assess financial risk protection for chronic disease patients in Nigeria.
Main Methods:
- A cross-sectional study involving 339 adult patients with chronic conditions (Hypertension, Diabetes, Tuberculosis, HIV).
- Data collected on sociodemographics, morbidity, household financing, and coping mechanisms.
- Statistical analysis using Chi-squared test to determine significant associations (p<0.05).
Main Results:
- A majority of patients (79.1%) paid out-of-pocket for chronic disease care, despite some having health insurance.
- Common coping strategies included missing clinic visits (42.8%) and forfeiting necessities (33.3%).
- The type of chronic disease was significantly associated with payment methods (p<0.01).
Conclusions:
- Out-of-pocket payments are prevalent for chronic disease care, even among insured individuals.
- Households resort to economically distressing coping strategies to fund healthcare.
- Targeted programs are essential to improve financial risk protection for chronic disease patients.
Background:
Chronic diseases contribute the highest to disease burden and deaths worldwide and require long-term access to health care. This study identified the payment methods and coping strategies for healthcare costs by patients with chronic diseases using public health facilities in Yenagoa, Bayelsa State, Nigeria.
Methods:
Three hundred and thirty-nine (339) adult patients, being managed for chronic conditions (Hypertension, Diabetes mellitus, Tuberculosis & HIV), were randomly selected from three specialist hospitals that are the major providers of specialized care for patients with chronic diseases in the State. Data on sociodemographic characteristics, morbidity patterns, household financing and coping with health expenditure were collected. Chi-squared test was used to identify significant associations. A p-value 0.05 was considered significant.
Results:
Majority were females 211(62%) and about a third were not working 113(33.3%). To pay for their chronic disease healthcare expenses, 268 (79.1%) paid out-of-pocket while 71 (20.9%) used social health insurance. Among the 120 (35.4%) patients who subscribed to a health insurance program, about 2 in 5 still paid out-of-pocket. Missing a clinic visit 145(42.8%) was the common coping strategy followed by patients having to forfeit necessities 113(33.3%) to cope with their healthcare costs. The type of chronic disease was statistically associated with payment methods adopted by patients (p<0.01).
Conclusions:
Most patients with chronic diseases rely on out-of-pocket payments for healthcare expenditures including patients with health insurance coverage. This has necessitated households to adopt coping strategies, found to be economically distressing, to source funds for healthcare needs. Targeted programmes are needed for patients with chronic diseases to enhance financial risk protection.
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