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Table 5 Cost of Surgical Care and Financial Catastrophe by Insurance Status

From: Does insurance protect individuals from catastrophic payments for surgical care? An analysis of Ghana’s National Health Insurance Scheme at Korle-Bu teaching Hospital

 Health insurance statusP-value (Fischer’s exact test)
InsuredUninsured
Out of pocket (OOP) expenditures Gh¢ ($USD)
 Mean OOP health expenditure (direct medical cost for surgery)997.1 (203)2,860.0<0.001
 Mean OOP health expenditures (direct medical cost for ancillary services)1100 (244)1,039.00.667
 Mean OOP non-medical cost/indirect health costs (transportation and lost wages)243 (54)218.00.657
 Total OOP health expenditures (direct & indirect costs)2238.7 (497)3,887.5 (863)<0.001
Financial Catastrophe %a,b
 Percent total OOP out of individual income40%61%0.037
 Percent total OOP out of house-hold expenditures25%53%<0.001
 Percent total OOP out of subsistence expendituresc67%142%<0.001
Percentage of individuals incurring catastrophic paymentsd
 Percentage of individuals incurring catastrophic health payments (income level)63%83%0.017
 Percentage of individuals incurring catastrophic health payments (subsistence level)58%94%<0.001
 Percentage of individuals incurring catastrophic health payments (house-hold level)87%98%0.008
  1. aFinancial catastrophe is defined as out of pocket payment for surgery which exceeds; 20% of the respondent’s income, 10% of the household expenditures, or 40% of the household’s net-food expenditures
  2. bPercent of the respondent’s annual income, house-hold expenditures, or subsistence expenditures that was spent on surgical care . i.e. the insured spent on average 40% of their annual income on surgical care
  3. cSubsistence expenditures: Total annual household expenditures minus food expenditures
  4. dPercentage of individuals incurring catastrophic health payments by insurance status at different catastrophic levels i.e. 63% of the insured incurred catastrophic payments for surgical care at the income level