Quality of Hypertension Management and Health Insurance Impact: An Assessment of Insured and Uninsured Patients with Systemic Hypertension in a Teaching Hospital in Ilorin, Nigeria

Abstract

Background Patient satisfaction is an important indicator used to measure quality of care and the performance of healthcare services. This study assessed patient satisfaction with the quality of hypertension care received by both insured and uninsured patients with systemic hypertension. Methods This comparative cross-sectional study was conducted among insured and uninsured patients with systemic hypertension attending the Medical Outpatient Department clinics of the University of Ilorin Teaching Hospital, Kwara State, Nigeria, from May to July, 2023. Data were collected from 95 patients from each group, selected by systematic random sampling; using an interviewer-administered, anonymous, structured close ended questionnaire. Different aspects of the healthcare services were assessed; these include patient registration process, waiting time, staff attitudes, laboratory services, availability and cost of prescribed drugs etc. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 27.0 software. Results The insured patients with systemic hypertension had a higher overall mean satisfaction (74.1±20.8) compared to the uninsured group (69.3±23.2), though this was not statistically significant (p value = 0.417). However, the insured patients with systemic hypertension had significant satisfaction scores compared to uninsured hypertensive group in the domains of waiting time (63.6± 24.9 vs 48.0 ± 25.8, p=0.000), drug cost and availability (73.9 ± 24.1 vs 56.2 ± 25.0, p=0.000), and cost of service and care (74.1±24.0 vs 59.8±26.0, p=0.000). Conclusions This study concluded that both insured and uninsured patients with systemic hypertension had comparable treatment, though the insured group had some better satisfaction scores in some of the assessed healthcare domains. The healthcare policy makers should endeavour to improve health insurance coverage, and utilize identified factors in policy formulation and implementation to encourage utilization of health insurance among patients.