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African Journal of Primary Health Care & Family Medicine
versão On-line ISSN 2071-2936
versão impressa ISSN 2071-2928
Resumo
KISHINDO, Mwaleso et al. Are outpatient costs for hypertension and diabetes care affordable? Evidence from Western Kenya. Afr. j. prim. health care fam. med. (Online) [online]. 2023, vol.15, n.1, pp.1-9. ISSN 2071-2936. http://dx.doi.org/10.4102/phcfm.v15i1.3889.
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
Palavras-chave : out-patient costs; non-communicable diseases; catastrophic healthcare expenditure; primary healthcare; comorbidity.