COMPARATIVE STUDY OF THE OUT-OF-POCKET EXPENDITURE ON DRUG COMPONENT OF HEALTHCARE TREATMENT IN AN NHIS VERSUS NON-NHIS OUT-PATIENTS CLINIC IN CENTRAL HOSPITAL, NIGERIA

ABSTRACT

 

Background: Health insurance is intended to reduce the financial burden of purchasing health care by pooling funds and sharing the risk of unexpected health events. Risk sharing mechanisms are particularly important in Sub-Saharan Africa where most countries dedicate insufficient resources to health care and most health care, including medicines, is financed out-of-pocket.

Objectives: To assess the cost of drug in NHIS versus Non-NHIS outpatient clinic and to determine satisfaction with the cost of drug component

Methods: The study was a retrospective analytical survey that was conducted on some prescriptions of enrollees and outpatients of the health services in Central Hospital, Benin City using auditing technique.

Results: The findings in this study show that the cost of drugs for Non-NHIS is very high (N8070) compare to that of NHIS (N807). Out patient who enrolled for the scheme, spend only 10% of non-enrollees expenses.  Out of the total number of outpatient that enrolled under NHIS from January – March 2019 while 1124 non-enrollee outpatients were diagnosed with malaria from Jan – March, 2019.

Conclusion: It can be concluded that the level of enrolment into the NHIS is still very poor which inevitably contributes to the poor health status of Nigerians and the dismal health indices recorded in our health institutions. The level of dissatisfaction in the scheme is also a cause for concern that requires immediate attention from both the HMO’s and the healthcare providers. However, it was recommended that there should be establishment of functional structures of arbitration to engage the scheme management constantly, health care providers and enrollees in order to minimize mistrust and improve uptake and service delivery.

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