Comparison of Financial Risk Protection among Health-Insured and Non-Insured Diabetic Patients in Kaduna, North West Nigeria

Abstract

Context: Diabetes mellitus poses a significant health and economic burden in Nigeria. With limited resources and a heavy reliance on out-of-pocket payments for healthcare, the cost of diabetes mellitus management creates financial hardships for individuals and households. Aim: This study aimed to compare financial risk protection between health-insured and non-insured diabetic patients in Kaduna State, Nigeria. Materials and Methods: It was a hospital-based cross-sectional study, involving 250 health-insured and 250 non-insured diabetic patients. Statistical Analysis: Data were analyzed using IBM SPSS Statistics version 25.0. Chi-square test and Fisher’s exact test were used for comparison between different groups with statistical significance set at P ≤ 0.05. Results: About 70% and 65% of the health-insured and non-insured patients, respectively, were protected from financial risk, with no statistically significant difference observed between the groups. Financial risk protection was significantly associated with levels of education (P = 0.001), occupation (P = 0.019), and religion (P = 0.018) in the health-insured group, while occupation (P = 0.015), income (0.012), and duration of diabetes (P = 0.001) were the statistically significant factors associated with financial risk protection among the non-insured group. Higher education and income levels positively impacted protection, while longer diabetes duration reduces the likelihood of financial risk protection. Conclusion: No significant difference was found in financial risk protection between health-insured and non-insured diabetic patients. Collaborative efforts between the NHIA, Health Maintenance Organizations, and healthcare service providers are recommended to improve the breadth and scope of coverage for diabetes mellitus treatments within the National Health Insurance Scheme to ensure adequate financial risk protection.