dc.contributor.author | Anderson, Geoffrey A | |
dc.contributor.author | Ilcisin, Lenka | |
dc.contributor.author | Kayima, Peter | |
dc.contributor.author | Abesiga, Lenard | |
dc.contributor.author | Benitez, Noralis Portal | |
dc.contributor.author | Ngonzi, Joseph | |
dc.contributor.author | Ronald, Mayanja | |
dc.contributor.author | Shrime, Mark G | |
dc.date.accessioned | 2022-02-02T15:59:47Z | |
dc.date.available | 2022-02-02T15:59:47Z | |
dc.date.issued | 2017-10-31 | |
dc.identifier.citation | Citation: Anderson GA, Ilcisin L, Kayima P, Abesiga L, Portal Benitez N, Ngonzi J, et al. (2017) Out-of pocket payment for surgery in Uganda: The rate of impoverishing and catastrophic expenditure at a government hospital. PLoS ONE 12(10): e0187293. https://doi.org/10.1371/journal. pone.0187293 | en_US |
dc.identifier.uri | http://ir.must.ac.ug/xmlui/handle/123456789/1366 | |
dc.description.abstract | Background and objectives
It is Ugandan governmental policy that all surgical care delivered at government hospitals in Uganda is to be provided to patients free of charge. In practice,however, frequent stock outs and broken equipment require patients to pay for large portions of their care out of their own pocket. The purpose of this study was to determine the financial impact on patients who undergo surgery at a government hospital in Uganda.
Methods
Every surgical patient discharged from a surgical ward at a large regional referral hospital in rural southwestern Uganda over a 3-week period in April 2016 was asked to participate.
Patients who agreed were surveyed to determine their baseline level of poverty and to assess the financial impact of the hospitalization. Rates of impoverishment and catastrophic expenditure were then calculated. An “impoverishing expense” is defined as one that pushes a household below published poverty thresholds. A “catastrophic expense” was incurred if the patient spent more than 10% of their average annual expenditures.
Results
We interviewed 295 out of a possible 320 patients during the study period. 46% (CI 40– 52%) of our patients met the World Bank’s definition of extreme poverty ($1.90/person/day).
After receiving surgical care an additional 10 patients faced extreme poverty, and 5 patients were newly impoverished by the World Bank’s definition ($3.10/person/day). 31% of patients faced a catastrophic expenditure of more than 10% of their estimated total yearly expenses. 53% of the households in our study had to borrow money to pay for care, 21% had to sell possessions, and 17% lost a job as a result of the patient’s hospitalization. Only 5% of our patients received some form of charity.
Conclusions and relevance
Despite the government’s policy to provide “free care,” undergoing an operation at a government hospital in Uganda can result in a severe economic burden to patients and their families. Alternative financing schemes to provide financial protection are critically needed. | en_US |
dc.description.sponsorship | LI received salary and travel support from
the Doris Duke Charitable Foundation through the
Harvard Medical School Doris Duke International
Clinical Research Fellow Program (http://dorisduke.
hms.harvard.edu/home). GAA received salary and
travel support from the Massachusetts General
Hospital Department of Surgery (http://wwwmassgeneral.org/surgery/?display=health-care professionals). MGS receives salary support from
the General Electric Foundation Safe Surgery 2020
program (http://safesurgery2020.org) and the
Steven C Kletjian Foundation. Salaries of the
research assistants and basic study materials were
funded through a grant from Boston Children’s
Hospital (http://www.childrenshospital.org/global health/about). The funders had no role in study
design, data collection and analysis, decision to
publish, or preparation of the manuscript. | en_US |
dc.language.iso | en | en_US |
dc.publisher | PLOS ONE | en_US |
dc.title | Out-of-pocket payment for surgery in uganda | en_US |
dc.title.alternative | The rate of impoverishing and catastrophic expenditure at a government hospital | en_US |
dc.type | Article | en_US |