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Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria

BACKGROUND: Out-of-pocket spending (OOPS) is the major payment strategy for healthcare in Nigeria. Hence, the paper assessed the determinants socio-economic status (SES) of OOPS and strategies for coping with payments for healthcare in urban, semi-urban and rural areas of southeast Nigeria. This pap...

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Autores principales: Onwujekwe, Obinna E, Uzochukwu, Benjamin SC, Obikeze, Eric N, Okoronkwo, Ijeoma, Ochonma, Ogbonnia G, Onoka, Chima A, Madubuko, Grace, Okoli, Chijioke
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851710/
https://www.ncbi.nlm.nih.gov/pubmed/20233454
http://dx.doi.org/10.1186/1472-6963-10-67
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author Onwujekwe, Obinna E
Uzochukwu, Benjamin SC
Obikeze, Eric N
Okoronkwo, Ijeoma
Ochonma, Ogbonnia G
Onoka, Chima A
Madubuko, Grace
Okoli, Chijioke
author_facet Onwujekwe, Obinna E
Uzochukwu, Benjamin SC
Obikeze, Eric N
Okoronkwo, Ijeoma
Ochonma, Ogbonnia G
Onoka, Chima A
Madubuko, Grace
Okoli, Chijioke
author_sort Onwujekwe, Obinna E
collection PubMed
description BACKGROUND: Out-of-pocket spending (OOPS) is the major payment strategy for healthcare in Nigeria. Hence, the paper assessed the determinants socio-economic status (SES) of OOPS and strategies for coping with payments for healthcare in urban, semi-urban and rural areas of southeast Nigeria. This paper provides information that would be required to improve financial accessibility and equity in financing within the public health care system. METHODS: The study areas were three rural and three urban areas from Ebonyi and Enugu states in South-east Nigeria. Cross-sectional survey using interviewer-administered questionnaires to randomly selected householders was the study tool. A socio-economic status (SES) index that was developed using principal components analysis was used to examine levels of inequity in OOPS and regression analysis was used to examine the determinants of use of OOPS. RESULTS: All the SES groups equally sought healthcare when they needed to. However, the poorest households were most likely to use low level and informal providers such as traditional healers, whilst the least poor households were more likely to use the services of higher level and formal providers such as health centres and hospitals. The better-off SES more than worse-off SES groups used OOPS to pay for healthcare. The use of own money was the commonest payment-coping mechanism in the three communities. The sales of movable household assets or land were not commonly used as payment-coping mechanisms. Decreasing SES was associated with increased sale of household assets to cope with payment for healthcare in one of the communities. Fee exemptions and subsidies were almost non-existent as coping mechanisms in this study CONCLUSIONS: There is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with government paying for the poor.
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spelling pubmed-28517102010-04-09 Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria Onwujekwe, Obinna E Uzochukwu, Benjamin SC Obikeze, Eric N Okoronkwo, Ijeoma Ochonma, Ogbonnia G Onoka, Chima A Madubuko, Grace Okoli, Chijioke BMC Health Serv Res Research article BACKGROUND: Out-of-pocket spending (OOPS) is the major payment strategy for healthcare in Nigeria. Hence, the paper assessed the determinants socio-economic status (SES) of OOPS and strategies for coping with payments for healthcare in urban, semi-urban and rural areas of southeast Nigeria. This paper provides information that would be required to improve financial accessibility and equity in financing within the public health care system. METHODS: The study areas were three rural and three urban areas from Ebonyi and Enugu states in South-east Nigeria. Cross-sectional survey using interviewer-administered questionnaires to randomly selected householders was the study tool. A socio-economic status (SES) index that was developed using principal components analysis was used to examine levels of inequity in OOPS and regression analysis was used to examine the determinants of use of OOPS. RESULTS: All the SES groups equally sought healthcare when they needed to. However, the poorest households were most likely to use low level and informal providers such as traditional healers, whilst the least poor households were more likely to use the services of higher level and formal providers such as health centres and hospitals. The better-off SES more than worse-off SES groups used OOPS to pay for healthcare. The use of own money was the commonest payment-coping mechanism in the three communities. The sales of movable household assets or land were not commonly used as payment-coping mechanisms. Decreasing SES was associated with increased sale of household assets to cope with payment for healthcare in one of the communities. Fee exemptions and subsidies were almost non-existent as coping mechanisms in this study CONCLUSIONS: There is the need to reduce OOPS and channel and improve equity in healthcare financing by designing and implementing payment strategies that will assure financial risk protection of the poor such pre-payment mechanisms with government paying for the poor. BioMed Central 2010-03-17 /pmc/articles/PMC2851710/ /pubmed/20233454 http://dx.doi.org/10.1186/1472-6963-10-67 Text en Copyright ©2010 Onwujekwe et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research article
Onwujekwe, Obinna E
Uzochukwu, Benjamin SC
Obikeze, Eric N
Okoronkwo, Ijeoma
Ochonma, Ogbonnia G
Onoka, Chima A
Madubuko, Grace
Okoli, Chijioke
Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria
title Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria
title_full Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria
title_fullStr Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria
title_full_unstemmed Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria
title_short Investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast Nigeria
title_sort investigating determinants of out-of-pocket spending and strategies for coping with payments for healthcare in southeast nigeria
topic Research article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851710/
https://www.ncbi.nlm.nih.gov/pubmed/20233454
http://dx.doi.org/10.1186/1472-6963-10-67
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