Department of Pediatrics, Lagos University Teaching Hospital, Lagos, Nigeria.
Department of Pediatrics, Faculty of Clinical Sciences, College of Medicine, University of Lagos/Lagos University Teaching Hospital, Lagos, Nigeria.
Pan Afr Med J. 2020 Jul 29;36:227. doi: 10.11604/pamj.2020.36.227.24636. eCollection 2020.
there is a paucity of data on the financial implications of sickle cell disease on households of affected children and their use of health insurance in Nigeria. This study assessed the awareness of health insurance, patterns of health service utilization and financial implications of sickle cell disease among children seeking care at a tertiary facility in Nigeria.
a structured questionnaire was administered to parents of 314 children with sickle cell disease attending the pediatric hematology unit of the Lagos University Teaching Hospital between May and December 2019.
mean age of the children was 91.5 ± 43.1 months. M: F was 1.17: 1. 45.5% of households earned above NGN 150,000 (USD 417) monthly. 71.3% of the parents had heard of health insurance but only 20.7% were enrolled in a health insurance scheme. Awareness of health insurance was significantly associated with social class (p=0.000) and monthly household income (p=0.000). 60.8% of the parents preferred pre-facility treatment. Social class (p=0.01) and monthly household income (p=0.001) were significantly associated with home treatment. Time on admission ranged from 2-18 days with an average of 4.31 days. Average cost of hospitalization was USD 148 ± USD 14.2 and total cost of care incurred was USD 20,787. Neither age of child (p=0.857), estimated household income (p=0.863) nor social class (p=0.397) was associated with cost of care.
a high cost of care was observed in our study population underscoring the need for increased awareness and access to health insurance for households of children with sickle cell disease.
关于尼日利亚镰状细胞病患儿家庭的经济负担及其对医疗保险的利用情况，相关数据匮乏。本研究评估了在尼日利亚一家三级医疗机构就诊的镰状细胞病患儿家庭对医疗保险的认知、卫生服务利用模式和镰状细胞病的经济负担。
2019 年 5 月至 12 月，对在拉各斯大学教学医院儿科血液科就诊的 314 名镰状细胞病患儿的家长进行了一项结构问卷调查。
患儿的平均年龄为 91.5±43.1 个月。男女比例为 1.17:1。45.5%的家庭月收入超过 150000 奈拉（417 美元）。71.3%的家长听说过医疗保险，但只有 20.7%的人参加了医疗保险计划。医疗保险意识与社会阶层（p=0.000）和家庭月收入（p=0.000）显著相关。60.8%的家长更喜欢在就诊前进行治疗。社会阶层（p=0.01）和家庭月收入（p=0.001）与家庭治疗显著相关。住院时间为 2-18 天，平均为 4.31 天。住院费用平均为 148 美元±14.2 美元，总医疗费用为 20787 美元。儿童年龄（p=0.857）、家庭收入估计值（p=0.863）和社会阶层（p=0.397）均与医疗费用无关。
我们的研究人群中观察到医疗费用较高，这突显了需要提高镰状细胞病患儿家庭对医疗保险的认识和获得医疗保险的机会。
