Predictors of Cost of Follow-up Care among Patients with Hypertension and Diabetes Mellitus Attending a Teaching Hospital, North Central, Nigeria

Abstract

Background: In sub-Saharan Africa, hypertension and diabetes mellitus (type II) remain major causes of cardiovascular disease. The prevalence of hypertension and diabetes remain high in Nigeria while the initial and follow-up management are almost entirely hospital-based. This constitutes huge financial burden not only to the patients, care givers and families, but also to the health system and the government. Information on basic cost of care of hypertension and diabetes and of those having both diseases as co-morbidities is still scanty in Nigeria. There is need to study the factors that strongly determine cost of follow-up care among this group of patients. Methodology: This study is a hospital-based cross-sectional study of 1,203 hypertensive and diabetic patients attending general and medical outpatient clinics of a teaching hospital in Nigeria. Results: The patients spend N6,401 ($32.16) on the average whenever they attend follow-up clinic. Close to threequarter (71.3%) of the patients spent more than 30 minutes to access follow-up clinic while similar proportion (74.3%) spent more than an hour waiting to be seen at the clinics. Major predictors of cost of follow-up care among hypertensive and Diabetics were; Drug, transportation and laboratory costs. Other predictors were; Male gender, long waiting time, accompanies persons; and co-morbidity of hypertension and diabetes. Conclusion: This study recommended that strategies that will reduce the cost of drugs, laboratory tests, and reducing waiting time will reduce the cost of managing hypertension and diabetes in Nigeria.