Out-of-Pocket Costs of Asthma Follow-Up Care in Adults in a Sub-Saharan African Country

Abstract

Asthma care imposes economic burden on affected patients. Patient costs for asthma care have not been documented in Africa. We aimed to determine the out-of-pocket cost of asthma follow-up care incurred by patients in Nigeria. We conducted a crosssectional study in three tertiary hospitals in southeastern and northwestern Nigeria. Poorly controlled asthma patients attending a follow-up visit in the respiratory clinic of the hospitals were surveyed. Sociodemographic, health-seeking behavior, and cost data were collected using a structured questionnaire. Of the 110 patients who completed the study, 56 (51%) were females. Also, 72 (65%) of the patients had known about their asthma illness for more than four years. Mean annual direct cost of asthma care was US$368.4 (±228) per patient. Medication cost accounted for the majority (87%) of this cost. Patient costs of care incurred did not differ significantly across age (P = 0.15), education (P = 0.23), marital status (0.49), residence (P = 0.47), or gender (P = 0.65) categories. We conclude that direct cost of care was found to be substantial among poorly controlled asthma patients. Further studies to estimate the costs incurred by patients with exacerbation and differing severity of the disease should be conducted.

Childhood Asthma in Nigeria: A Review of the Burden and Challenges of Management

“…[12] Poor health system The Nigerian health system involves heterogeneous health care providers comprising public, private for-profit, community-based organisation (CBO), faith-based organisation (FBO), and traditional healthcare providers. [87] There is often little or no synergy among these providers, hence health care delivery is not synchronised and organised. Health care financing is mostly by direct (out-of-pocket) payment with very few proportions of the populace covered by any form of health insurance.…”

“…Health care financing is mostly by direct (out-of-pocket) payment with very few proportions of the populace covered by any form of health insurance. [87,88] This often leads to health financing catastrophe in a bid to meet health demands. [54,88] The management of childhood asthma often impose a huge financial burden on the family particularly if the payment has to be done out-of-pocket and this often leads to seeking alternative medical care in unorthodox and substandard settings.…”

How Do Out-of-Pocket Expenditures Affect Healthcare: A Qualitative Insight of Acute Exacerbation among Asthma Patients

“…Some of them measured only direct medical costs, while some of them determined direct medical and non-medical costs. On the other hand, very few determined OOPCs of asthma or AEA [23,24]. To date, there is no information available about OOPCs among AEA patients in Pakistan.…”