Assessment of Catastrophic Health Expenditure Incurred by Hypertensive Patients Attending a SemiUrban Tertiary Hospital in South-South Nigeria

Abstract

The cost of managing hypertension poses a huge financial burden on individuals and households, especially those paying out-of-pocket.  This has a significant consequence on patients' compliance with management, and many have been thrown into huge financial crisis as a  result of the catastrophic expenditure resulting from the management of hypertension. This study assessed the direct cost of hypertensive health care; determined the presence of catastrophic health expenditure (CHE) or otherwise and its associates/predictors  (when present) among hypertensive patients accessing care in a semiurban tertiary hospital in South-South Nigeria, using a cross- sectional study design. Three hundred and twenty respondents were selected using a systematic random sampling technique. Data on sociodemographic indices, monthly cost of accessing hypertensive care, cost of living and sundry matters were collected using a pre- tested interviewer-administered questionnaire and analyzed using IBM® SPSS version 23. The mean age of respondents was 54.8 years (±  16.5), and 43.4% was at least 60 years old. The majority Of the respondents (55.9%), were females. The average monthly cost of managing hypertension was ₦36,814; with the highest amount spent on laboratory investigations and drugs. Nine out of ten respondents  were exposed to CHE. Patients’ educational status and presence of co-morbidities were associated with CHE. However  being self-employed was the only predictor of CHE, with self-employed respondents having 5 times more odds of CHE than the  unemployed. The study showed that the vast majority of hypertensives paying out-of -pocket suffer a substantial financial burden and are  exposed to financial catastrophe. Governments at all levels need to formulate polices that will lead to increase in the access to  affordable and timely quality health care for hypertensive patients in order to reduce the huge financial burden currently incurred by  them.