Cardiovascular disease prevention in rural Nigeria in the context of a community based health insurance scheme: QUality Improvement Cardiovascular care Kwara-I (QUICK-I)

BMC Public Health

Study Protocol

Navin Bindraban¹  Shade Alli²  Tanimola Akande³  Oladimeji Akeem Bolarinwa³  Ferdinand Wit⁴  Joep Lange⁴  Marleen Hendriks⁵  Constance Schultsz⁶  Aina Olufemi Odusola⁷  Lizzy Brewster⁸  Peju Adenusi⁹  William Redekop^1,10  Kayode Agbede^1,11  Albert Vollaard^1,12 

[1] Dept of Cardiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands;Dept of Cardiology, Lagoon Hospitals, 8 Marine Road, Apapa, Lagos, Nigeria;Dept of Epidemiology and Community Health, University of Ilorin Teaching Hospital, P.M.B. 1459, postal code 240001, Ilorin, Nigeria;Dept of Global Health, Academic Medical Center, University of Amsterdam, Pietersbergweg 17, 1105 BM, Amsterdam, The Netherlands;Dept of Global Health, Academic Medical Center, University of Amsterdam, Pietersbergweg 17, 1105 BM, Amsterdam, The Netherlands;Dept of Neurology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands;Dept of Global Health, Academic Medical Center, University of Amsterdam, Pietersbergweg 17, 1105 BM, Amsterdam, The Netherlands;Oxford University Clinical Research Unit, Hospital for Tropical Diseases, 190 Ben Ham Tu, Ho Chi Min City, District 5, Vietnam;Dept of Global Health, Academic Medical Center, University of Amsterdam, Pietersbergweg 17, 1105 BM, Amsterdam, The Netherlands;PharmAccess Foundation, 1c Raymond Njoku Street, S.W. Ikoyi, Lagos, Nigeria;Depts of Internal and Vascular Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands;Hygeia Nigeria Ltd, 13B Idejo Street, Victoria Island, Lagos, Nigeria;Institute for Medical Technology Assessment, Erasmus University Rotterdam, Burgemeester Oudlaan 50, 3062 PA, Rotterdam, The Netherlands;Ogo Oluwa Hospital, 64/65 Ahmadu Bello Way, Bacita, Kwara State, Nigeria;PharmAccess Foundation, Pietersbergweg 17, 1105 BM, Amsterdam, The Netherlands;

关键词: Insurance Program;    Health Insurance Scheme;    Health Insurance Fund;    Community Health Insurance;    Exception Reporting;   

DOI  :  10.1186/1471-2458-11-186

 received in 2011-02-15, accepted in 2011-03-25,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundCardiovascular diseases (CVD) are a leading contributor to the burden of disease in low- and middle-income countries. Guidelines for CVD prevention care in low resource settings have been developed but little information is available on strategies to implement this care. A community health insurance program might be used to improve patients' access to care. The operational research project "QUality Improvement Cardiovascular care Kwara - I (QUICK-I)" aims to assess the feasibility of CVD prevention care in rural Nigeria, according to international guidelines, in the context of a community based health insurance scheme.Methods/DesignDesign: prospective observational hospital based cohort study.Setting: a primary health care centre in rural Nigeria.Study population: 300 patients at risk for development of CVD (patients with hypertension, diabetes, renal disease or established CVD) who are enrolled in the Hygeia Community Health Plan.Measurements: demographic and socio- economic data, physical and laboratory examination, CVD risk profile including screening for target organ damage. Measurements will be done at 3 month intervals during 1 year. Direct and indirect costs of CVD prevention care will be estimated.Outcomes: 1) The adjusted cardiovascular quality of care indicator scores based on the "United Kingdom National Health Services Quality and Outcome Framework". 2) The average costs of CVD prevention and treatment per patient per year for patients, the clinic and the insurance company. 3) The estimated net health care costs of standard CVD prevention care per quality-adjusted life year gained.Analysis: The primary outcomes, the score on CVD quality indicators and cost data will be descriptive. The quality scores and cost data will be used to describe the feasibility of CVD prevention care according to international guidelines. A cost-effectiveness analysis will be done using a Markov model.DiscussionResults of QUICK-I can be used by policy makers and professionals who aim to implement CVD prevention programs in settings with limited resources. The context of the insurance program will provide insight in the opportunities community health insurance may offer to attain sustainable chronic disease management programs in low resource settings.Trial registrationThis protocol has been registered at ISRCTN, ID number: ISRCTN47894401.

【 授权许可】

CC BY   
© Hendriks et al; licensee BioMed Central Ltd. 2011