Department of Health Administration and Management, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria.
National Health Insurance Authority, Abuja, Nigeria.
BMC Nephrol. 2024 Jan 23;25(1):29. doi: 10.1186/s12882-024-03459-4.
BACKGROUND: Evidence of willingness to pay for kidney replacement therapy is scarce in low-middle-income countries, including Nigeria's Formal Sector Social Health Insurance Programme. The study, therefore, assessed the willingness to pay for haemodialysis among chronic kidney disease patients in Abuja, Nigeria. METHODS: The study adopted a cross-sectional survey design. We used the contingent valuation method to estimate the maximum stated willingness to pay (WTP) for haemodialysis among end-stage kidney disease (ESKD) patients. We obtained informed written consent from respondents before data collection. The socio-demographic characteristics and willingness to pay data were summarized using descriptive statistics. We evaluated the mean differences in respondents' WTP using Mann-Whitney and Kruskal-Wallis tests. All variables that had p < 0.25 in the bivariate analysis were included in the Generalized Linear Model (gamma with link function) to determine the predictors of the WTP for one's and another's haemodialysis. The level of significance in the final model was ρ < 0.05. RESULTS: About 88.3% and 64.8% of ESKD patients were willing to pay for personal and altruistic haemodialysis, correspondingly. The mean annual WTP for haemodialysis for one's and altruistic haemodialysis was USD25,999.06 and USD 1539.89, respectively. Private hospital patients were likelier to pay for their haemodialysis (β = 0.39, 95%CI: 0.21 to 0.57, p < 0.001). Patients attending public-private partnership hospitals were less likely to pay for altruistic haemodialysis than those attending public hospitals (β = -1.65, 95%CI: -2.51 to -0.79, p < 0.001). CONCLUSIONS: The willingness to pay for haemodialysis for themselves and others was high. The type of facility ESKD patients attended influenced their willingness to pay for haemodialysis. The findings highlight the need for policies to enhance affordable and equitable access to haemodialysis in Nigeria through pre-payment mechanisms and altruistic financing strategies.
背景:在中低收入国家,包括尼日利亚正规部门社会健康保险计划在内,愿意为肾脏替代疗法付费的证据很少。因此,本研究评估了阿布贾慢性肾脏病患者对血液透析的支付意愿。
方法:本研究采用横断面调查设计。我们使用条件价值评估法来估计终末期肾病患者对血液透析的最大支付意愿(WTP)。在收集数据之前,我们获得了受访者的书面知情同意。使用描述性统计方法总结社会人口统计学特征和支付意愿数据。我们使用 Mann-Whitney 和 Kruskal-Wallis 检验评估受访者 WTP 的均值差异。在双变量分析中 p 值<0.25 的所有变量均被纳入广义线性模型(gamma 连接函数),以确定对个人和他人血液透析的 WTP 的预测因素。最终模型的显著性水平为 ρ<0.05。
结果:大约 88.3%和 64.8%的终末期肾病患者分别愿意为个人和利他主义血液透析付费。个人和利他主义血液透析的年平均 WTP 分别为 25999.06 美元和 1539.89 美元。私营医院的患者更有可能为自己的血液透析付费(β=0.39,95%CI:0.21 至 0.57,p<0.001)。与公立医院相比,参加公私合作医院的患者不太可能为利他主义血液透析付费(β=-1.65,95%CI:-2.51 至-0.79,p<0.001)。
结论:愿意为自己和他人进行血液透析的意愿很高。终末期肾病患者就诊的机构类型影响了他们对血液透析的支付意愿。研究结果强调需要通过预付款机制和利他主义融资策略制定政策,以提高尼日利亚血液透析的可负担性和公平性。
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