TITLE:
Management of Hypertension (HTN) in a Cardiology Department in Bamako (Mali): Financial Aspects
AUTHORS:
Hamidou Oumar Bâ, Ichaka Menta, Ibrahima Sangaré, Noumou Sidibé, Youssouf Camara, Souleymane Coulibaly, Hamidou Camara, Cheick Hamala Fofana, Aladji Traoré, Adama Sogodogo, Mamadou Touré, Kéita Asmaou Maiga, Doumbia Coumba Thiam, Adama Daou, Kassoum Mamourou Sanogo
KEYWORDS:
Hypertension, New Patients, Untreated Patients, Costs, Cardiology, Bamako
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.9 No.6,
June
26,
2019
ABSTRACT: Background: Studies on financial
aspects of High blood pressure management are rare and old without
differentiating categories of expenses. On the other hand there is an evolution
in health system with the introduction of a medical insurance. Objective: We performed this study to
estimate costs related to insurance status. Methodology: The prospective study on
patients aged 15 years and older extended from 01 May to 31
August 2016 and was carried out in the cardiology department of the University Hospital Gabriel Touré. Only newly detected or
untreated hypertensive patients were included. Sociodemographic data, those on
physical examination and financial management (transport,
consultation, labor tests and purchase of drugs) were collected. Regarding costs,
patients were directly asked about: how much did you spend
for transport, consultation, labor tests and drugs? Data analysis was
carried out by comparing patients with health insurance (Ins+) and those
without it (Ins?). The recorded data were inserted in a MS Access database, preliminarily
processed by MS Excel and imported to SPSS version 20 for analysis. Results: Mean total cost of care was 57,018 FCFA [50,139 - 63,897] (around 92 USD).
It was 50,072 [42,182 - 57,963] for the Ins? group against 79,670 [66,777 - 92,563] for the Ins+
group with a p value 0.0001. Highest amounts for spending were for cardiovascular medication and labor
tests with means of 19,255 FCFA (32 USD) and 18,813 FCFA (30 USD). Mean consultation fee
was significantly higher for Ins+ patients: 4064 FCFA with IC (95%) [3210 - 4917] versus 3124 with
IC (95%) [2774 - 3474] for Ins? patients and p = 0.018. For ECG, however, mean
costs were higher for Ins? patients with 6460 [5944 - 6976] against 5115
[4871 - 5360] for Ins+ patients, p = 0.001. Conclusion: Health insurance has few
subscribers compared to patients requiring medical care. It increases the
global costs of care while facilitating access to care for those who benefit
from it.