Cost burden for accessing paediatric emergency services at a tertiary health facility

Abstract

Background: The economic burden of seeking paediatric emergency care could be high and this could also negate the philosophy of equity, social justice, universal access and social health protection for all. This study assessed the cost, payment modalities and economic impacts for accessing paediatric emergency services in a tertiary hospital in Nigeria.

Methods: Cross sectional survey with pre-tested structured questionnaires administered by trained interviewers to158 parents of children discharged from a tertiary hospital emergency unit over a 2-month period. Verifiable information on various financial expenditures during emergency episode as well as respondents' perceptions and background socioeconomic status were collected. Proxy estimates for economic impacts were calculated based on single need per household for emergency care. Descriptive analysis of the data was done using SPSS version20.

Result: Majority (45.6%) of the 158 children were aged 1 - 5years, girls (52.5%) and were diagnosed with single morbidity (86. 7%). Primary diagnoses were bronchopneumonia 21.5%, diarrhoea disease 20.9% and malaria 14.6%. The major contributors to cost of healthcare were the cost of admission and drugs. Payment at the point of access to healthcare was almost universal (98. 7%). Study shows that41.8% and 52.5% of households spent more than 40% of their monthly non-food and 50% of their monthly non-subsistent earnings on the index paediatric emergency.

Conclusion: The cost of accessing paediatric emergencies could put a high proportion of uninsured households at risk of being impoverished. Findings provide further imperative for the intensification of efforts at scaling up of the social insurance scheme to cover all household as a means of assuring social health protection for all.

Keywords: Cost; Paediatric Emergencies; UPTH; Children; Rivers State; Nigeria