Economic Burden of Inpatient Wound Dressing in Nigeria: Implication for Catastrophic Household Expenditure

Abstract

Background: The literature is replete with family impoverishment resulting from out of pocket healthcare financing on the Africa continent. In Nigeria the healthcare insurance scheme is evolving and requires wider coverage. The aim of this study is to examine catastrophic household expenditure emanating from daily or alternate day wound dressing.Methods. The study was based on a descriptive cross-sectional research design to investigate the economic burden of daily or alternate day wound dressing among hospitalized patients in selected teaching hospitals in south west Nigeria. The inclusion criteria focused on inpatients about to be discharged or already spent minimum of four weeks in hospital. The data collection instrument was pre-tested with a coefficient of stability of 0.774. Respondents were selected via convenience sampling while an interview administered questionnaire was used to elicit information on wound care from patients in medical surgical wards. Covid-19 protocols were strictly adhered to and ethical approval was sought from each hospital.Results: The result revealed that the mean age of the respondents was 44.95 ± 16.12. Two-thirds were men who are artisans and traders with only secondary school education. Over 70% of the respondents have between 5 and 10 family members, more than 50% earn less than ₦50000 per month. The majority have no comorbidities (79.5%), about 50% were on daily dressing which required 1–5 moderate or major dressing packs per week. The length of hospital stay for the majority of the respondents (85.3%) was less than 11 weeks.Conclusions: The daily or alternate day wound dressing requires a financial input beyond the coping capacity of the indigenous Nigerian families. The Nigerian government should scale up coverage of health insurance scheme to cover artisans, small traders and other low income earners to reduce the incidence of catastrophic household expenditure.