Saskia Mostert1, Festus Njuguna2, Renske H M van der Burgt1, Joyce Musimbi2, Sandra Langat2, Jodi Skiles3, Anneloes Seijffert1, Mei N Sitaresmi4, Terry A Vik3, Peter M van de Ven5, Gertjan J L Kaspers1. 1. Department of Pediatric Oncology-Hematology, VU University Medical Center, Amsterdam, The Netherlands. 2. Department of Child Health and Pediatrics, Moi Teaching and Referral Hospital, Eldoret, Kenya. 3. Department of Pediatric Hematology-Oncology, Indiana University School of Medicine, Indianapolis, Indiana. 4. Department of Pediatrics, Dr. Sardjito Hospital, Yogyakarta, Indonesia. 5. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands.
Abstract
BACKGROUND: Patients at Kenyan public hospitals are detained if their families cannot pay their medical bills. Access to health insurance and waiving procedures to prevent detention may be limited. This study explores the perspectives of health-care providers (HCP) on health-insurance access, waiving procedures, and hospital detention practices. PROCEDURE: A self-administered structured questionnaire was completed by 104 HCP (response rate 78%) involved in childhood cancer care. RESULTS: The perspectives of respondents were as follows: all children with cancer should have health insurance according to 96% of HCP. After parents apply for health insurance, it takes too long before treatment costs are covered (67% agree). Patients with childhood cancer without health insurance have a higher chance of abandoning treatment (82% agree). Hospitals should waive bills of all children with cancer when parents have payment difficulties (69% agree). Waiving procedures take too long (75%). Parents are scared by waiving procedures and may decide never to return to the hospital again (68%). Poor families delay visiting the hospital because they fear hospital detention and first seek alternative treatment (92%). When poor families finally come to the hospital, the disease is in advanced stage already (94%). Parents sometimes have to abandon their detained child at the hospital if they cannot pay hospital bills (68%). Detention of children at the hospital if parents cannot pay their medical bills is not approved by 84% of HCP. CONCLUSIONS: HCP acknowledge that access to health insurance needs improvement and that waiving procedures contribute to treatment abandonment. By far, most HCP disapprove of hospital detention practices. These factors warrant urgent attention and adjustment.
BACKGROUND:Patients at Kenyan public hospitals are detained if their families cannot pay their medical bills. Access to health insurance and waiving procedures to prevent detention may be limited. This study explores the perspectives of health-care providers (HCP) on health-insurance access, waiving procedures, and hospital detention practices. PROCEDURE: A self-administered structured questionnaire was completed by 104 HCP (response rate 78%) involved in childhood cancer care. RESULTS: The perspectives of respondents were as follows: all children with cancer should have health insurance according to 96% of HCP. After parents apply for health insurance, it takes too long before treatment costs are covered (67% agree). Patients with childhood cancer without health insurance have a higher chance of abandoning treatment (82% agree). Hospitals should waive bills of all children with cancer when parents have payment difficulties (69% agree). Waiving procedures take too long (75%). Parents are scared by waiving procedures and may decide never to return to the hospital again (68%). Poor families delay visiting the hospital because they fear hospital detention and first seek alternative treatment (92%). When poor families finally come to the hospital, the disease is in advanced stage already (94%). Parents sometimes have to abandon their detained child at the hospital if they cannot pay hospital bills (68%). Detention of children at the hospital if parents cannot pay their medical bills is not approved by 84% of HCP. CONCLUSIONS: HCP acknowledge that access to health insurance needs improvement and that waiving procedures contribute to treatment abandonment. By far, most HCP disapprove of hospital detention practices. These factors warrant urgent attention and adjustment.
Authors: Krisna Handayani; Tyas C Sijbranda; Maurits A Westenberg; Nuria Rossell; Mei N Sitaresmi; Gertjan Jl Kaspers; Saskia Mostert Journal: Int J Health Policy Manag Date: 2020-08-01
Authors: Joy E Obayemi; Elizabeth B Card; Octavian Shirima; Ajay Premkumar; Honest Massawe; Neil P Sheth Journal: Glob Health Res Policy Date: 2022-09-02