Ekwochi Uchenna, Osuorah D Chidiebere, Ndu Ikenna K, Ezenwosu Osita U, Amadi Ogechukwu F, Nwokoye Ikenna C, Odetunde O Israel
Department of Pediatrics, Enugu State University Teaching Hospital, Parklane, Nigeria.
Child Survival Unit, Medical Research Council (UK), The Gambia unit, Fajara, The Gambia.
Clinicoecon Outcomes Res. 2014 Jan 16;6:29-35. doi: 10.2147/CEOR.S54674. eCollection 2014.
Neonatal illnesses usually require long hospital stays and specialized care and/or facilities, which usually results in huge medical bills. With more than 70% of people in Nigeria living on less than US$2 per day, these bills are not affordable to many families' livelihoods.
This study aims to determine the average cost of managing neonatal illnesses in Enugu in southeast Nigeria and the proportion of family income spent on these illnesses. It further seeks to ascertain the cost of various components in the management of neonatal diseases.
This is a longitudinal and descriptive study involving 106 newborns admitted to the sick baby unit of the Enugu State University Teaching Hospital and the out-of-pocket medical expenditure in the management of their illnesses.
A hundred and six newborns participated in the study. All (100%) medical bills were out-of-pocket payments, and 103 (97.2%) of these were catastrophic health expenditure (more than 10% of total family monthly income). The average duration of hospital stay and cost of managing a neonatal illness was 12.86±8.81 days and ₦36,382±19,389.72 (US$223±119), respectively. This expenditure amounted to 157%, 71%, and 25% of total monthly family income for the low, middle, and upper socioeconomic class families, respectively, with a mean percentage of 85%. Families with a total monthly income of less than ₦10,000 (US$61), ₦10,000-49,999 (US$61-306), and ₦50,000-100,000 (US$306-612) and more than ₦100,000 (US$612) on average spent 683%, 108%, 54%, and 20% of their monthly income on their newborn's illness. Hospital and utility bills compared with bills accruing from drug and laboratory investigations account for a significantly larger proportion of total cost incurred in neonatal sepsis (₦23,499±14,987 [US$144±92], P=0.001), low birth weight (₦39,863±24,003 [US$224±147], P=0.001), severe anemia (₦40,504±13,923 [US$248±85], P=0.001), transient tachypnea of the newborn (₦10,083±1,078 [US$62±7], P=0.001), birth asphyxia (₦24,398±14,096 [US$149±86], P=0.001), and meningitis (₦26,731±7,675 [US$164±47], P=0.001), whereas cost for laboratory investigations was significantly higher for neonatal jaundice (₦11,690±3,169 [US$72±19], P=0.001). There was a strong positive correlation between duration of hospital stay and total medical cost incurred (r=0.897, P=0.001).
Health expenditure on neonatal illness is high and leads to catastrophic expenditure for the majority of households in the state. There is a need for effective health insurance schemes to help subsidize and cushion this disastrous and impoverishing health expenditure on families for improved neonatal survival in Nigeria.
新生儿疾病通常需要长时间住院以及专业护理和/或设施，这通常会导致巨额医疗费用。在尼日利亚，超过70%的人每天生活费不足2美元，许多家庭难以承担这些费用。
本研究旨在确定尼日利亚东南部埃努古市新生儿疾病的平均管理成本以及家庭收入中用于这些疾病的比例。它还试图确定新生儿疾病管理中各个组成部分的成本。
这是一项纵向描述性研究，涉及106名入住埃努古州立大学教学医院病儿病房的新生儿及其疾病管理中的自付医疗费用。
106名新生儿参与了研究。所有（100%）医疗费用均为自付费用，其中103例（97.2%）为灾难性医疗支出（超过家庭月总收入的10%）。新生儿住院的平均时长和疾病管理成本分别为12.86±8.81天和36,382±19,389.72奈拉（223±119美元）。这笔支出分别占低、中、高社会经济阶层家庭月总收入的157%、71%和25%，平均百分比为85%。月总收入低于10,000奈拉（61美元）、10,000 - 49,999奈拉（61 - 306美元）、50,000 - 100,000奈拉（306 - 612美元）以及超过100,000奈拉（612美元）的家庭，平均分别将其月收入的683%、108%、54%和20%用于新生儿疾病。在新生儿败血症（23,499±14,987奈拉[144±92美元]，P = 0.001）、低出生体重（39,863±24,003奈拉[224±147美元]，P = 0.001）、重度贫血（40,504±13,923奈拉[248±85美元]，P = 0.001）、新生儿短暂性呼吸急促（10,083±1,078奈拉[62±7美元]，P = 0.001）、出生窒息（24,398±
