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Economic burden of the therapeutic management of mental illnesses and its effect on household purchasing power
Open accessAbstract
Cost or burden of illness studies for mental illnesses has helped define the magnitude of their negative effects on the household, community and national economy. Despite its many benefits, there is a paucity of these studies among Nigerians being managed for mental illnesses. This study was aimed at assessing the economic burden of mental illnesses and its effect on household purchasing power. The study was descriptive cross-sectional in design conducted among 284 out-patients with five categories of mental illnesses at the Neuropsychiatric Hospital, Aro recruited via a systematic sampling technique. Data collection was quantitative using a semi-structured interviewer-administered tool. Participants provided the actual direct costs and estimates of indirect costs incurred during their most recent inpatient admission and their first clinic visit after discharge. Parametric and non-parametric statistical tests were conducted on the direct and estimated indirect costs respectively after testing them for normality using the Q-Q plot with statistical significance determined at p<0.05. Almost 96% of respondents finance their healthcare costs by themselves or their family with >50% earning <US$1.8 per day. Their mean direct and estimated indirect costs were (US$23.1±US$11.3 and US$15±US$28). There were no statistically significant differences in the mean direct and estimated indirect costs incurred by participants across the categories of mental illnesses. A significantly higher proportion of participants could afford the essential goods (88%) compared to those who could afford luxurious goods (29%) with p<0.001. The mean direct costs incurred by those who could afford the essential and luxurious goods were significantly higher than those who could not following a t-test. The median estimated indirect costs incurred by those who could not afford luxurious goods differed significantly from those who could with the Mann Whitney U-test. Participants with mental illnesses face a high economic burden in managing their condition with the majority unable to afford luxurious goods. Affordability was also associated with incurring more direct costs.
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“In southeast Nigeria (where Imo State is located), 27% of households incur catastrophic health expenditures, and this rate was higher for rural regions and for people with a mental illness (factoring in both direct and indirect costs of the illness) [65–67].”
From Integrating mental health into primary care: evaluation of the Health Action for Psychiatric Problems In Nigeria including Epilepsy and SubstanceS (HAPPINESS) pilot project (2022) · cites this paper as [66]
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Metadata
- Authors
- Agboola, A. A., Esan, O. T., Afolabi, O. T., Soyinka, T. A., Oluwaranti, A. O., & Adetayo, A.
- Affiliations
- Obafemi Awolowo University (NG)
- Corresponding author
- Esan, Oluwaseun T.
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2018-09-10
- Volume
- 13
- Issue
- 9
- Pages
- e0202396
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6130881
- OpenAlex
- W2891166813
- Cited by
- 29
- References
- 34
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 9 · 2023: 4 · 2022: 4 · 2021: 1 · 2020: 1 · 2019: 3
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Greater South Information System
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Healthcare Systems and Reforms
- Keywords
- economic burden of mental illness, household purchasing power, out-of-pocket health care costs, direct costs, indirect costs, psychiatric treatment, outpatients, Nigeria
- MeSH terms
- Adolescent, Adult, Aged, Mental Disorders, Costs and Cost Analysis, Cross-Sectional Studies, Family Characteristics, Female, Humans, Male, Middle Aged, Cost of Illness
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