Out of pocket spending for healthcare services: a study assessing the relationship between payment methods and perceived satisfaction with the quality of care in a tertiary health facility in Delta State, Nigeria

Abstract

Objective: To assess the relationship between payment methods in a tertiary health facility and clients perceived quality of care.

Method: This was a cross-sectional descriptive study. The instrument was a pre tested, semi-structured self-administered questionnaire. Descriptive statistics as well regression analysis was done to show statistically significant associations.

Results: The findings reveal different modes money was made available for payment for health services. On the whole, about 98% of payment was through out-of pocket spending (user-charges) with most respondents using their own money. Although this financing method shown to be associated with good quality service delivery as perceived by the respondents', however it remains a regressive mode of paying for health services.

Conclusion: The findings from this study have brought to the fore that out-of pocket payments for health services can be an effective mechanism for achieving desired healthcare delivery in tertiary health care. However, there remain the problems of inequities in tertiary healthcare coverage. This suggests that charges levied for tertiary health services should therefore be linked to the broader package of financing through health insurance coverage.

Keywords: out-of-pocket payment, user fees, quality, tertiary health services; Nigeria