Health-care providers’ perspectives on health-insurance access, waiving procedures, and hospital detention practices in Kenya

Saskia Mostert, Festus Njuguna, Renske H.M. van der Burgt, Joyce Musimbi, Sandra Langat, Jodi Skiles, Anneloes Seijffert, Mei N. Sitaresmi, Terry Vik, Peter M. van de Ven, Gertjan J.L. Kaspers

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Patients at Kenyan public hospitals are detained if their families cannot pay their medical bills. Access to health insurance and waiving procedures to prevent detention may be limited. This study explores the perspectives of health-care providers (HCP) on health-insurance access, waiving procedures, and hospital detention practices. Procedure: A self-administered structured questionnaire was completed by 104 HCP (response rate 78%) involved in childhood cancer care. Results: The perspectives of respondents were as follows: all children with cancer should have health insurance according to 96% of HCP. After parents apply for health insurance, it takes too long before treatment costs are covered (67% agree). Patients with childhood cancer without health insurance have a higher chance of abandoning treatment (82% agree). Hospitals should waive bills of all children with cancer when parents have payment difficulties (69% agree). Waiving procedures take too long (75%). Parents are scared by waiving procedures and may decide never to return to the hospital again (68%). Poor families delay visiting the hospital because they fear hospital detention and first seek alternative treatment (92%). When poor families finally come to the hospital, the disease is in advanced stage already (94%). Parents sometimes have to abandon their detained child at the hospital if they cannot pay hospital bills (68%). Detention of children at the hospital if parents cannot pay their medical bills is not approved by 84% of HCP. Conclusions: HCP acknowledge that access to health insurance needs improvement and that waiving procedures contribute to treatment abandonment. By far, most HCP disapprove of hospital detention practices. These factors warrant urgent attention and adjustment.

Original languageEnglish (US)
Article numbere27221
JournalPediatric Blood and Cancer
Volume65
Issue number8
DOIs
StatePublished - Aug 1 2018

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Kenya
Health Insurance
Health Personnel
Parents
Neoplasms
Social Adjustment
Public Hospitals
Health Care Costs
Fear
Therapeutics

Keywords

  • health insurance
  • health-care providers
  • hospital detention practices
  • waiving procedures

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Hematology
  • Oncology

Cite this

Mostert, S., Njuguna, F., van der Burgt, R. H. M., Musimbi, J., Langat, S., Skiles, J., ... Kaspers, G. J. L. (2018). Health-care providers’ perspectives on health-insurance access, waiving procedures, and hospital detention practices in Kenya. Pediatric Blood and Cancer, 65(8), [e27221]. https://doi.org/10.1002/pbc.27221

Health-care providers’ perspectives on health-insurance access, waiving procedures, and hospital detention practices in Kenya. / Mostert, Saskia; Njuguna, Festus; van der Burgt, Renske H.M.; Musimbi, Joyce; Langat, Sandra; Skiles, Jodi; Seijffert, Anneloes; Sitaresmi, Mei N.; Vik, Terry; van de Ven, Peter M.; Kaspers, Gertjan J.L.

In: Pediatric Blood and Cancer, Vol. 65, No. 8, e27221, 01.08.2018.

Research output: Contribution to journalArticle

Mostert, S, Njuguna, F, van der Burgt, RHM, Musimbi, J, Langat, S, Skiles, J, Seijffert, A, Sitaresmi, MN, Vik, T, van de Ven, PM & Kaspers, GJL 2018, 'Health-care providers’ perspectives on health-insurance access, waiving procedures, and hospital detention practices in Kenya', Pediatric Blood and Cancer, vol. 65, no. 8, e27221. https://doi.org/10.1002/pbc.27221
Mostert, Saskia ; Njuguna, Festus ; van der Burgt, Renske H.M. ; Musimbi, Joyce ; Langat, Sandra ; Skiles, Jodi ; Seijffert, Anneloes ; Sitaresmi, Mei N. ; Vik, Terry ; van de Ven, Peter M. ; Kaspers, Gertjan J.L. / Health-care providers’ perspectives on health-insurance access, waiving procedures, and hospital detention practices in Kenya. In: Pediatric Blood and Cancer. 2018 ; Vol. 65, No. 8.
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abstract = "Background: Patients at Kenyan public hospitals are detained if their families cannot pay their medical bills. Access to health insurance and waiving procedures to prevent detention may be limited. This study explores the perspectives of health-care providers (HCP) on health-insurance access, waiving procedures, and hospital detention practices. Procedure: A self-administered structured questionnaire was completed by 104 HCP (response rate 78{\%}) involved in childhood cancer care. Results: The perspectives of respondents were as follows: all children with cancer should have health insurance according to 96{\%} of HCP. After parents apply for health insurance, it takes too long before treatment costs are covered (67{\%} agree). Patients with childhood cancer without health insurance have a higher chance of abandoning treatment (82{\%} agree). Hospitals should waive bills of all children with cancer when parents have payment difficulties (69{\%} agree). Waiving procedures take too long (75{\%}). Parents are scared by waiving procedures and may decide never to return to the hospital again (68{\%}). Poor families delay visiting the hospital because they fear hospital detention and first seek alternative treatment (92{\%}). When poor families finally come to the hospital, the disease is in advanced stage already (94{\%}). Parents sometimes have to abandon their detained child at the hospital if they cannot pay hospital bills (68{\%}). Detention of children at the hospital if parents cannot pay their medical bills is not approved by 84{\%} of HCP. Conclusions: HCP acknowledge that access to health insurance needs improvement and that waiving procedures contribute to treatment abandonment. By far, most HCP disapprove of hospital detention practices. These factors warrant urgent attention and adjustment.",
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AU - Skiles, Jodi

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