{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T14:34:56Z","timestamp":1791470096584,"version":"4.3.4"},"reference-count":33,"publisher":"BMJ","issue":"6","license":[{"start":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T00:00:00Z","timestamp":1623110400000},"content-version":"unspecified","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"the Consortium for Advanced Research Training in Africa (CARTA).","award":["Grant No--B 8606.R02, Grant No: 107768\/Z\/15\/Z"],"award-info":[{"award-number":["Grant No--B 8606.R02, Grant No: 107768\/Z\/15\/Z"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,5,12]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Given that the mechanism for financial protection is underdeveloped in Nigeria, out-of-pocket (OOP) payment for treating cardiovascular disease could impose substantial financial burden on individuals and their families. This study estimated the burden of OOP expenditures incurred by a cohort of patients with cardiovascular disease (CVD) in Ibadan, Nigeria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design and settings<\/jats:title>\n                    <jats:p>This study used a descriptive cross-sectional study design. A standardised survey questionnaire originally developed by Initiative for Cardiovascular Health Research in Developing Countries was used to electronically collect data from all the 744 patients with CVD who accessed healthcare between 4 November 2019 and 31 January 2020 in the cardiology departments of private and public hospitals in Ibadan, Nigeria. Baseline characteristics of respondents were presented using percentages and proportions. The OOP payments were reported as means\u00b1SDs. Costs\/OOP payments were in Nigerian Naira (NGN). The average US dollar to NGN at the time of data collection was \u20a6362.12 per $1. All quantitative data were analysed using STATA V.15.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcome measures<\/jats:title>\n                    <jats:p>The burden of outpatient, inpatient and rehabilitative care OOP payments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Majority of the patients with CVD were within the age range of 45\u201374 years and 68.55% of them were women. The diagnostic conditions reported among patients with CVD were hypertensive heart failure (84.01%), dilated cardiomyopathy (4.44%), ischaemic heart disease (3.9%) and anaemic heart failure (2.15%). Across all the hospital facilities, the annual direct and indirect outpatient costs were \u20a6421 595.7\u00b1\u20a6855 962.0 ($1164.2\u00b1$2363.8) and \u20a619 146.5\u00b1\u20a653 610.1 ($52.87\u00b1$148.05). Similarly, the average direct and indirect OOP payments per hospitalisation across all facilities were \u20a6182 302.4\u00b1\u20a6249 090.4 ($503.43\u00b1$687.87) and \u20a614 700.8\u00b1\u20a6 69 297.1 ($40.60\u00b1$191.37), respectively. The average rehabilitative cost after discharge from index hospitalisation was \u20a630 012.0 ($82.88).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The burden of OOP payment among patients with CVD is enormous. There is a need to increase efforts to achieve universal health coverage in Nigeria.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-044044","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T12:49:25Z","timestamp":1623156565000},"page":"e044044","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Burden of out-of-pocket payments among patients with cardiovascular disease in public and private hospitals in Ibadan, South West, Nigeria: a cross-sectional study"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4697-3081","authenticated-orcid":false,"given":"Folashayo","family":"Adeniji","sequence":"first","affiliation":[{"name":"Health Policy and Management, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,6,8]]},"reference":[{"key":"2025121400122321000_11.6.e044044.1","first-page":"198","article-title":"The costs of cardiovascular disease in Brazil: a brief economic comment","volume":"91","author":"Balbinotto Neto","year":"2008","journal-title":"Arq Bras Cardiol"},{"key":"2025121400122321000_11.6.e044044.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61696-1"},{"key":"2025121400122321000_11.6.e044044.3","doi-asserted-by":"publisher","DOI":"10.1097\/HJH.0b013e328010775f"},{"key":"2025121400122321000_11.6.e044044.4","unstructured":"Opie LH , Mayosi BM . 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