Direct and Indirect Costs of Non-surgical Treatment for Acute Tonsillitis in Children in Southeast Nigeria

Maduka Donatus Ughasoro, James Onuorah Akpeh (), Nneamaka Echendu, Somkene Okpala, Nneka Getrude Mgbachi, Ogochukwu Chinelo Okanya and Obinna Emmanuel Onwujekwe
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Maduka Donatus Ughasoro: University of Nigeria Enugu Campus
James Onuorah Akpeh: University of Nigeria Enugu-Campus
Nneamaka Echendu: University of Nigeria Teaching Hospital
Somkene Okpala: University of Nigeria Teaching Hospital
Nneka Getrude Mgbachi: University of Nigeria Teaching Hospital
Ogochukwu Chinelo Okanya: Institute of Management and Technology
Obinna Emmanuel Onwujekwe: University of Nigeria Enugu Campus

PharmacoEconomics - Open, 2021, vol. 5, issue 4, No 17, 755-764

Abstract: Abstract Background Acute tonsillitis has become one of the main reasons why children visit healthcare facilities in Nigeria. Presently, there is no information on the costs of its treatment, and this study aimed at determining these costs. Methods The study was conducted in two hospitals located in southeast Nigeria. The information was obtained in two ways: (1) retrospectively from the medical records of children treated for acute tonsillitis over a period of 5 years and (2) cross-sectionally from children who presented with complaints of acute tonsillitis over a period of 7 months. The information obtained was the costs of self-medication and hospital treatment, and the payment mechanisms used to settle these costs. The human capital method approach was used to estimate the indirect cost (loss in productivity) from the caregivers’ absenteeism from work. Results The mean costs of self-medication and hospital treatment for acute tonsillitis in children were €3.85 and €13.48, respectively. The indirect cost was €11.31. The mean total cost of treatment of acute tonsillitis was €23.80. The proportion of households that suffered catastrophic health expenditure (CHE) from the treatment of acute tonsillitis was 55 (55%). CHE was highest [22 (91.7%)] in the lowest socio-economic quartile compared to households in the highest quartile [4 (16.7%)], and the difference was statistically significant (p = 0.02). Of the 72 participants whose payment mechanisms were documented, the proportion who paid out of pocket was 53 (73.6%), and 19 (26.4%) used the National Health Insurance Scheme. Conclusion The costs of treatment for children with acute tonsillitis were high, and most of these costs were settled out-of-pocket. The costs for laboratory investigations, drugs, and productivity loss contributed to these high costs. There is a need to cover the costs of non-surgical treatment of acute tonsillitis in social health insurance and improve efforts to increase the coverage of the health insurance scheme.

Date: 2021
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DOI: 10.1007/s41669-021-00259-6

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