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Cost of treatment as a barrier to access and continuity of healthcare for patients with mental ill-health in Lagos, Nigeria

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Author(s): Olufemi B. Olugbile | Ayodele O. Coker | Mathew P. Zachariah

Journal: Healthcare in Low-resource Settings
ISSN 2281-7824

Volume: 1;
Issue: 1;
Start page: e8;
Date: 2013;
Original page

Keywords: cost of treatment | barrier to access | continuity of healthcare | Nigeria

ABSTRACT
In Nigeria, there are several barriers to access to effective mental healthcare, e.g. cost, distance to the mental health facility, social stigma, cultural beliefs, attitudes and taboos. This study aimed at i) determining the cost of treatment of a random sample of psychiatric patients and to compare the sample with a matched group of patients from the internal medical department clinics; ii) assessing the impact of cost on access to care and maintenance treatment for the study group in the context of their exclusion from the Lagos State free health services and the National Health Insurance Scheme. Medical records of 100 patients currently attending the outpatients’ clinic of the Department of Psychiatry of the Lagos State University Teaching Hospital (Ikeja, Nigeria) were randomly selected and audited. A similar exercise was also conducted for patients attending the medical outpatients’ clinic in the same hospital. The monthly costs of prescribed medications were computed and compared. The monthly cost of treatment of patients from the Department of Psychiatry compared to patients with physical ailments from the medical outpatients’ clinic was found to be significant vis à vis the average income of average Nigerians. Contrary to expectations, the mean cost of drug treatment borne by medical outpatients was much higher (N=2549.07 vs N=1904.5) (P
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