Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya
Background: Diabetes and hypertension pose a significant socio-economic burden in developing countries such as Kenya, where financial risk-protection mechanisms remain inadequate. This proves to be a great barrier towards achieving universal health care in such settings unless mechanisms are put in...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
AOSIS
2023-09-01
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| Series: | African Journal of Primary Health Care & Family Medicine |
| Subjects: | |
| Online Access: | https://phcfm.org/index.php/phcfm/article/view/3889 |
| _version_ | 1797668307171540992 |
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| author | Mwaleso Kishindo Jemima Kamano Ann Mwangi Thomas Andale Grace W. Mwaura Obed Limo Kenneth Too Richard Mugo Ephantus Maree Wilson Aruasa |
| author_facet | Mwaleso Kishindo Jemima Kamano Ann Mwangi Thomas Andale Grace W. Mwaura Obed Limo Kenneth Too Richard Mugo Ephantus Maree Wilson Aruasa |
| author_sort | Mwaleso Kishindo |
| collection | DOAJ |
| description | Background: Diabetes and hypertension pose a significant socio-economic burden in developing countries such as Kenya, where financial risk-protection mechanisms remain inadequate. This proves to be a great barrier towards achieving universal health care in such settings unless mechanisms are put in place to ensure greater access and affordability to non-communicable disease (NCD) management services.
Aim: This article aims to examine outpatient management services costs for patients with diabetes and hypertension attending public primary healthcare facilities.
Setting: The study was conducted in Busia and Trans-Nzoia counties in Western Kenya in facilities supported by the PIC4C project, between August 2020 and December 2020.
Methods: This cross-sectional survey included 719 adult participants. Structured interviewer-administered questionnaires were used to collect information on healthcare-seeking behaviour and associated costs. The annual direct and indirect costs borne by patients were computed by disease type and level of healthcare facility visited.
Results: Patients with both diabetes and hypertension incurred higher annual costs (KES 13 149) compared to those with either diabetes (KES 8408) or hypertension (KES 7458). Patients attending dispensaries and other public healthcare facilities incurred less direct costs compared to those who visited private clinics. Furthermore, a higher proportionate catastrophic healthcare expenditure of 41.83% was noted among uninsured patients.
Conclusion: Despite this study being conducted in facilities that had an ongoing NCDs care project that increased access to subsidised medication, we still reported a substantially high cost of managing diabetes and hypertension among patients attending primary healthcare facilities in Western Kenya, with a greater burden among those with comorbidities.
Contribution: Evidenced by the results that there is enormous financial burden borne by patients with chronic diseases such as hypertension and diabetes; we recommend that universal healthcare coverage that offers comprehensive care for NCDs be urgently rolled out alongside strengthening of lower-level public healthcare systems. |
| first_indexed | 2024-03-11T20:27:13Z |
| format | Article |
| id | doaj.art-61cbac0444be411baeb8548ae704bcd1 |
| institution | Directory Open Access Journal |
| issn | 2071-2928 2071-2936 |
| language | English |
| last_indexed | 2024-03-11T20:27:13Z |
| publishDate | 2023-09-01 |
| publisher | AOSIS |
| record_format | Article |
| series | African Journal of Primary Health Care & Family Medicine |
| spelling | doaj.art-61cbac0444be411baeb8548ae704bcd12023-10-02T12:39:41ZengAOSISAfrican Journal of Primary Health Care & Family Medicine2071-29282071-29362023-09-01151e1e910.4102/phcfm.v15i1.38891063Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western KenyaMwaleso Kishindo0Jemima Kamano1Ann Mwangi2Thomas Andale3Grace W. Mwaura4Obed Limo5Kenneth Too6Richard Mugo7Ephantus Maree8Wilson Aruasa9Academic Model Providing Access to Healthcare, EldoretAcademic Model Providing Access to Healthcare, Eldoret, Kenya; and School of Medicine, Moi University, Eldoret, Kenya; and Division of Non-Communicable Disease, Ministry of Health, NairobiDepartment of Mathematics, Physics, and Computing, Moi University, EldoretAcademic Model Providing Access to Healthcare, Eldoret, Kenya; and Moi Teaching and Referral Hospital, EldoretAcademic Model Providing Access to Healthcare, Eldoret, Kenya; and Moi Teaching and Referral Hospital, EldoretAcademic Model Providing Access to Healthcare, EldoretAcademic Model Providing Access to Healthcare, EldoretAcademic Model Providing Access to Healthcare, EldoretDivision of Non-Communicable Disease, Ministry of Health, NairobiMoi Teaching and Referral Hospital, EldoretBackground: Diabetes and hypertension pose a significant socio-economic burden in developing countries such as Kenya, where financial risk-protection mechanisms remain inadequate. This proves to be a great barrier towards achieving universal health care in such settings unless mechanisms are put in place to ensure greater access and affordability to non-communicable disease (NCD) management services. Aim: This article aims to examine outpatient management services costs for patients with diabetes and hypertension attending public primary healthcare facilities. Setting: The study was conducted in Busia and Trans-Nzoia counties in Western Kenya in facilities supported by the PIC4C project, between August 2020 and December 2020. Methods: This cross-sectional survey included 719 adult participants. Structured interviewer-administered questionnaires were used to collect information on healthcare-seeking behaviour and associated costs. The annual direct and indirect costs borne by patients were computed by disease type and level of healthcare facility visited. Results: Patients with both diabetes and hypertension incurred higher annual costs (KES 13 149) compared to those with either diabetes (KES 8408) or hypertension (KES 7458). Patients attending dispensaries and other public healthcare facilities incurred less direct costs compared to those who visited private clinics. Furthermore, a higher proportionate catastrophic healthcare expenditure of 41.83% was noted among uninsured patients. Conclusion: Despite this study being conducted in facilities that had an ongoing NCDs care project that increased access to subsidised medication, we still reported a substantially high cost of managing diabetes and hypertension among patients attending primary healthcare facilities in Western Kenya, with a greater burden among those with comorbidities. Contribution: Evidenced by the results that there is enormous financial burden borne by patients with chronic diseases such as hypertension and diabetes; we recommend that universal healthcare coverage that offers comprehensive care for NCDs be urgently rolled out alongside strengthening of lower-level public healthcare systems.https://phcfm.org/index.php/phcfm/article/view/3889out-patient costsnon-communicable diseasescatastrophic healthcare expenditureprimary healthcarecomorbidity. |
| spellingShingle | Mwaleso Kishindo Jemima Kamano Ann Mwangi Thomas Andale Grace W. Mwaura Obed Limo Kenneth Too Richard Mugo Ephantus Maree Wilson Aruasa Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya African Journal of Primary Health Care & Family Medicine out-patient costs non-communicable diseases catastrophic healthcare expenditure primary healthcare comorbidity. |
| title | Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya |
| title_full | Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya |
| title_fullStr | Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya |
| title_full_unstemmed | Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya |
| title_short | Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya |
| title_sort | are outpatient costs for hypertension and diabetes care affordable evidence from western kenya |
| topic | out-patient costs non-communicable diseases catastrophic healthcare expenditure primary healthcare comorbidity. |
| url | https://phcfm.org/index.php/phcfm/article/view/3889 |
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