Health‑Care Financing among Patients Admitted for Open‑Heart Surgery in Enugu

Background: Cardiovascular diseases have been noted to be expensive to manage and tend to cause significant morbidity and financial burden to affected individuals and households. Objective: This study aimed to determine the various sources of health financing among patients admitted to UNTH Ituku/Ozalla for open-heart surgery. Methodology: Twenty‑five patients admitted for cardiac surgery over a 6‑month period were selected for the study. A structured  questionnaire was administered to the patients or their caregivers. Data were analyzed using SPSS version 20. Results: There were 25 respondents who were admitted during the study period, this comprised 17 children and 8 adults. Amongthe respondents 24 (96%) paid out of pocket, 1 (4%) was by government tax. The major sources of funds were from personal savings 56% and goodwill from friend’s relations, faith-based organizations (4%), while 36% of the respondents borrowed money for the surgery. Three of the respondents had a form of health insurance, while 22 (88%) had no form of health insurance. The mean monthly income of the households was 86,320 (81,384.7) Naira and the mean monthly food expenditure was 33,200 (15934.76) Naira. About 72% (18) of the subjects knew about the National Health Insurance Scheme (NHIS), 4 (16%) knew about the Voluntary Health Insurance Scheme (VHIS), while 84% did not know about the VHIS. However, about 56% of the subjects were willing to enroll under the NHIS voluntary scheme. The cardiac surgery was catastrophic for 96% of the respondents. Conclusion: Cardiac surgery causes a significant financial burden to individuals and households. Individuals and households should be properly counselled on the benefits of health insurance. The government should increase funding for cardiovascular health and  strengthen the health insurance system. Keywords: Cardiac surgery, cardiovascular disease, health financin

Atrial septal defects: Pattern, clinical profile, surgical techniques and outcome at Innova heart hospital: A 4-year review

Background: Atrial septal defect (ASD) is a congenital heart defect that leads to shunting of blood between left and right atria. It may be asymptomatic and sometimes may present with heart failure. Surgical repair is definitive, but currently non-surgical procedure is used to close the defect. Materials and Methods: It is a retrospective study of patients who underwent transcatheter closure of ASD at Innova Heart Hospital, Hyderabad, India. Echocardiography was repeated at intervals of 24 hours, then at 1, 3 and 6 months after the procedure to assess complications. The morphological characteristics of the ASD, including its diameter, location, shape and the width of surrounding septal margins, were also evaluated. Results: From April 2007 to June 2011, 69 consecutive children (29 males, 40 females) with a median age of 9.0 years (range = 3.2-19 years) registered with diagnosis of ASD. The median weight was 31.5 kg (range = 7.5-39.0 kg). Five patients (7.2%) were young children aged 3-5 years. Forty-four (63.8%) of these children presented with symptoms of heart failure, whereas 47 (68.1%) of the cases repaired with device were large-sized ASD. The most common interventional procedures done were Searcare Heart® and Amplatzer® technique with a highest success rate obtained in 2010. Conclusions: ASD is a common congenital heart disease with a high success rate for those who undergo intervention