Difference in Outcomes among Hypertensive Patients with or without Government-funded Healthcare Coverage: A Retrospective Review of Electronic Medical Records in a Large Private Hospital in Abuja

Abstract Background: In Africa, particularly in countries like Nigeria, poor health outcomes are prevalent, with many people lacking access to essential health services. While global research highlights disparities in health outcomes for individuals with chronic conditions based on their health insurance type or payment method, there is a lack of empirical studies in Africa investigating these disparities. Objective: This study aimed to identify differences in blood pressure (BP) and hospital stay outcomes between hypertensive patients who use publicly funded insurance schemes and those who use private health coverage types in Nigeria. Materials and Methods: A retrospective review was conducted of electronic medical records of 1086 patients with essential hypertension (International Classification of Diseases 10) from January 2017 to January 2018 at a private Hospital in Abuja. Multinomial logistic regression analysis was used to estimate the odds ratios (OR) for adverse outcomes in patients with government and non-government-funded health coverage. Results: We found that patients with government-funded insurance were more likely to have elevated diastolic BP [DBP] (OR: 1.65, 95% confidence interval [CI]: 1.39–1.95, P < 0.001). Females were less likely to have elevated systolic BP (OR 0.77, 95% CI 0.64–0.91, P = 0.003) and DBP (OR 0.83, 95% CI 0.70–0.99, P = 0.044) when compared to males. Conclusions: While public healthcare coverage is improving in Nigeria, insured patients still face a limited selection of medical services and may not receive specific therapy types even when deemed necessary, compared to privately insured patients. This may contribute to the difference in outcomes seen among these patients.