Quality of Hypertension Management and Health Insurance Impact: An Assessment of Insured and Uninsured Patients with Systemic Hypertension in a Teaching Hospital in Ilorin, Nigeria
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Date
2024-07-15
Authors
Agede, O., Daramola, O., Joseph, A., Jimoh, M., Ibrahim, S., Bojuwoye, M., Sanni, N., Akande, T.
Journal Title
Journal ISSN
Volume Title
Publisher
Published by College of Medicine, University of Malawi and National body of Medical Association of Malawi
Abstract
Background
Patient satisfaction is an important indicator used to measure quality of care and the performance of healthcare services. This study
assessed patient satisfaction with the quality of hypertension care received by both insured and uninsured patients with systemic
hypertension.
Methods
This comparative cross-sectional study was conducted among insured and uninsured patients with systemic hypertension attending the
Medical Outpatient Department clinics of the University of Ilorin Teaching Hospital, Kwara State, Nigeria, from May to July, 2023.
Data were collected from 95 patients from each group, selected by systematic random sampling; using an interviewer-administered,
anonymous, structured close ended questionnaire. Different aspects of the healthcare services were assessed; these include patient
registration process, waiting time, staff attitudes, laboratory services, availability and cost of prescribed drugs etc. Data analysis was
done using Statistical Package for the Social Sciences (SPSS) version 27.0 software.
Results
The insured patients with systemic hypertension had a higher overall mean satisfaction (74.1±20.8) compared to the uninsured group
(69.3±23.2), though this was not statistically significant (p value = 0.417). However, the insured patients with systemic hypertension
had significant satisfaction scores compared to uninsured hypertensive group in the domains of waiting time (63.6± 24.9 vs 48.0 ±
25.8, p=0.000), drug cost and availability (73.9 ± 24.1 vs 56.2 ± 25.0, p=0.000), and cost of service and care (74.1±24.0 vs 59.8±26.0,
p=0.000).
Conclusions
This study concluded that both insured and uninsured patients with systemic hypertension had comparable treatment, though the
insured group had some better satisfaction scores in some of the assessed healthcare domains. The healthcare policy makers should
endeavour to improve health insurance coverage, and utilize identified factors in policy formulation and implementation to encourage
utilization of health insurance among patients.
Description
Keywords
Hypertension management, Insurance, Quality of care, Teaching hospital, Uninsured