加纳某转诊医院国家健康保险计划投保高血压患者的自付费用及相关因素
Out-of-pocket payments and associated factors among hypertensive patients insured under the National Health Insurance Scheme in a referral hospital, Ghana.
摘要(中文译文)
自付费用是包括加纳在内的许多中低收入国家医疗融资中的常见组成部分。尽管加纳实施了国家健康保险计划，该计划预期能够防范灾难性自付费用，但患者仍然需要以某种形式支付费用，这对健康状况的改善产生了负面影响。我们研究了在加纳霍霍市一所转诊医院就诊的、参加国家健康保险计划的高血压患者中自付费用的发生率和自我报告的影响。这是一项横断面研究，于2022年2月至5月期间对389名高血压患者使用结构化问卷进行调查。收集的数据使用Stata软件15版进行分析。我们采用描述性统计和逻辑回归分析数据。统计学显著性设定为p<0.05。共有97.2%的受访者在接受医疗服务时支付了自付费用，其中97.1%的支付发生在领取药物时。29.1%的受访者报告在支付自付费用方面存在困难，这与曾经借钱以支付医疗费用（aOR=2.52；95% CI：1.31-4.88；p=0.006）、自付费用影响就医（aOR=5.52；95% CI：2.74-11.11；p<0.001）以及拥有替代的高血压治疗方式（aOR=2.93；95% CI：1.60-5.38；p=0.001）相关。自付费用在高血压患者利用医疗服务中普遍存在。这引发了对实现可持续发展目标3.4（旨在控制非传染性疾病）和目标3.8（旨在确保全民健康覆盖）进展的担忧。药物是高血压患者个人支付自付费用的主要医疗服务项目，因此凸显了确保药物可及性和可获得性以满足可持续发展目标3的全球目标的必要性，这也是由于高血压的长期治疗需求所致。
Abstract
Out-of-pocket (OOP) payments are a common component of healthcare financing in many low-and middle-income countries including Ghana. Despite implementation of the National Health Insurance Scheme in Ghana which is expected to protect against catastrophic OOP payments, patients still make some form of payments with its attendant negative implications for improved health status. We examined the prevalence and self-reported effects of OOP payments among hypertensive patients insured under the National Health Insurance Scheme attending a referral hospital in Hohoe, Ghana. This was a cross-sectional study conducted among 389 hypertensive patients between February and May 2022 using a structured questionnaire. Data collected were analysed using Stata software version 15. We employed descriptive statistics and logistic regression in analysing the data. Statistical significance was considered at p < 0.05. A total of 97.2% respondents made OOP payments in receiving healthcare with 97.1% of those who made such payments having made them at the point of receiving drugs. Difficulty in making OOP payments was reported by 29.1% of the respondents and this was associated with ever borrowing money to cover health expense (aOR=2.52; 95% CI: 1.31-4.88; p = 0.006), OOP payments affecting hospital attendance (aOR=5.52; 95% CI: 2.74-11.11; p < 0.001) and having an alternative form of treating hypertension (aOR=2.93; 95% CI: 1.60-5.38; p = 0.001). OOP payments are widespread in the utilisation of healthcare for hypertensive patients. This raises concerns about progress towards the attainment of Sustainable Development Goals (SDGs) 3.4 which seeks to control non-communicable diseases and SDG 3.8 which seeks to ensure universal health coverage. Medications or drugs are the major healthcare services for which individual hypertensive patients made OOP payments thus highlighting the need ensure availability and accessibility of drugs to meet the global targets of SDG 3 and due to the long-term treatment requirements of hypertension.
如何引用
AMA
Angela Nana Esi Ackon, Hubert Amu, Martin Amogre Ayanore. Out-of-pocket payments and associated factors among hypertensive patients insured under the National Health Insurance Scheme in a referral hospital, Ghana.. PloS one. 2026; doi:10.1371/journal.pone.0348971.
APA
Angela Nana Esi Ackon, Hubert Amu, Martin Amogre Ayanore (2026). Out-of-pocket payments and associated factors among hypertensive patients insured under the National Health Insurance Scheme in a referral hospital, Ghana.. PloS one. https://doi.org/10.1371/journal.pone.0348971
GB/T 7714
Angela Nana Esi Ackon, Hubert Amu, Martin Amogre Ayanore. Out-of-pocket payments and associated factors among hypertensive patients insured under the National Health Insurance Scheme in a referral hospital, Ghana.[J]. PloS one, 2026 doi:10.1371/journal.pone.0348971.
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