Assessment of Direct Causes and Costs of Medical Admissions in Bingham University Teaching Hospital – Jos, Nigeria

Abstract

Background: As health‑care costs continue to rise and the population ages, an individual Nigerian continues to experience financial hardship in settling medical bills, especially when health insurance schemes are still far from reality for most Nigerians, making health‑care financing burdensome in Nigeria like many developing countries. This has made out‑of‑pocket expenditure the most common form of health‑care financing. Aims: This study assessed the average costs, duration, and causes of inpatient admission so as to know the direct costs associated with medical care for proper health‑care planning. Settings and Design: This was a pilot study of a prospective cohort design whereby all patients were admitted to medical wards during the study period. Materials and Methods: Cost analysis was performed from the societal perspective, but included only direct medical care cost for this analysis. Patients input charts and pharmacy dispensing charts of all patients admitted to medical wards between May and July 2015 were reviewed. All costs were in local currency (Naira) using the average exchange rates proposed by Central Bank of Nigeria for June 2015. Statistical Analysis Used: Statistical analysis was carried out using SPSS version 20. Results: A total of 293 out of 320 patients met inclusion criteria and were assessed. Female patients admitted during the study period had an overall higher mean cost of care ₦84, 303.94 ± 6860.56 (95% confidence interval [CI]: 68,991.65–96,103.27) compared to male patients ₦68, 601.59 ± 57,178.37 (95% CI: 59,081.51–78,121.67) (P < 0.102). Civil servants had higher mean overall costs of care ₦90, 961.70 ± 105,175.62 (95% CI: 65,883.46–116,039.94) (P < 0.203). Conclusions: The higher prevalence of female patients with higher mean cost of inpatient care in this study suggests that Jos females may be more health conscious than their male counterparts. Overall mean cost of inpatient care stay was not proportional to the length of stay, suggesting early discharge from hospital did not necessarily eliminate the cost of patient management.