title: Sources of healthcare financing among surgical patients in a rural Niger Delta practice in Nigeria.
abstract: BACKGROUND
  The environmental degradation following crude oil exploration in the Niger Delta has resulted in poverty for local rural dwellers. For those who are ill, if herbal treatments and/or self-medication with orthodox drugs are unsuccessful, the only alternative is expensive medical treatment in clinics. Surgical patients in a rural clinic may have to stay beyond than the normal 7 days if they are unable to pay their hospital bill; because this limits bed availability, there is an impacts on the hospital's economic management. This study aimed to determine the pattern of hospital bill payment among rural surgical patients in a rural Nigerian community, including the sources of finance for bill payment, in order to determine ways to resolve this issue.
  
  
  METHODS
  This cross-sectional study was conducted in a rural community in the Niger Delta area (Bethesda Clinic Ngo) over 5 years (2005-2009).
  
  
  RESULTS
  In the 5 year study period, 3712 patients were seen, of which 229 were surgical patients who consented to the study. Their ages ranged from 4 to 97 years (mean 45.6 ± 13.5 years) and most were fish farmers (79.91%), secondary-school leavers (56.33%) and of the Christian religion (86.03%). The association of these characteristics with a greater than 7 day hospital stay was statistically significant (p < 0.05). The most prevalent surgical procedure was herniorrhaphy but the longest staying patients were those who had an ectopic pregnancy (23.32 ± 7.52 days), cesarean section (19.51 ± 6.73 days), appendectomy (18.46 ± 6.82 days) and exploratory laparotomy (17.33 ± 8.32 days). The hospital bill ranged from US$33.3 to $500, with a mean of $105.7 ± 0.043. Their sources of finance for the hospital bill were multiple but mainly personal savings (71.18%). Few (3.06%) had knowledge of the National Health Insurance Scheme, but when informed about it 84.28% were willing to enroll.
  
  
  CONCLUSIONS
  The sources of finance for payment of hospital bills were multiple but the most common were personal savings and family members.
authors: University of Port Harcourt Teaching Hospital, Nigeria. pdienye@yahoo.com
authors: P O
authors: PO
authors: Dienye
authors: S F
authors: SF
authors: Brisibe
authors: R
authors: R
authors: Eke
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D009549:Nigeria; D011203:Poverty / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013514:Surgical Procedures, Operative / Q000191:economics*; D055815:Young Adult