Coping with the economic burden of non-communicable diseases among hypertensive and diabetic patients in private and public health facilities in Ado-Ekiti, Nigeria

TL;DR

This study compares how patients in private and public health facilities in Nigeria cope with the economic burden of hypertension and diabetes.

Contribution

The study provides insights into coping strategies used by patients in different healthcare settings for non-communicable diseases.

Findings

Most patients paid out-of-pocket, with more private patients using instalment payments.

Delayed treatment was the most common coping strategy in both private and public facilities.

Lower education and out-of-pocket payments were linked to using more coping strategies.

Abstract

To assess and compare how private and public health facilities patients cope with the economic burden of non-communicable diseases.

Comparative cross-sectional study.

Thirty-nine private and eleven public health facilities in Ado-Ekiti, Nigeria

Three hundred and forty-eight (Private:173; Public:175) patients with hypertension or diabetes, or both were recruited.

Specific coping methods and numbers of coping strategies used by participants, as well as the perceived ability of participants to cope with the economic burden of non-communicable diseases.

Majority of participants paid through out-of-pocket (OOP) than through health insurance(HI) (Private:OOP:90.2% HI:9.8%; Public:OOP:94.3% HI:5.7%; p=0.152). More participants in private used instalment payments(p<0.001). However, other coping strategies showed no significant difference in both groups(p>0.05). Delayed treatment (Private:102; Public:95) was the most used strategy in both arms, and the number of strategies used by the participants showed no significant difference(p=0.061). Lower levels of education, out-of-pocket payment, increasing number of clinic visits, and hospital admission were associated with the use of higher numbers of coping strategies in both groups while being female and retired/unemployed were associated with the private arm.

Although most patients in both groups pay out-of-pocket and use detrimental coping strategies, more patients in private arm use instalment payment, a non-detrimental method. Healthcare providers, especially public providers, should adopt policies encouraging patients to use non-detrimental coping strategies to meet their healthcare expenditures.

None declared