Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
Out of pocket payment for assisted reproductive techniques: How to households recover?
Introduction: The cost of ART remains amongst the most prevalent barriers to treatment, especially in resource limited countries where many people are poor and inadequately covered by private and public health insurances. This study aims to assess the financial consequences of out of pocket payment...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Obstetrics and Gynaecology
2018
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867614244386635776 |
|---|---|
| access_status_str | Open Access |
| author | Vinoos, Latiefa |
| author2 | Dyer, Silke |
| author_browse | Dyer, Silke Vinoos, Latiefa |
| author_facet | Dyer, Silke Vinoos, Latiefa |
| author_sort | Vinoos, Latiefa |
| collection | Thesis |
| description | Introduction: The cost of ART remains amongst the most prevalent barriers to treatment, especially in resource limited countries where many people are poor and inadequately covered by private and public health insurances. This study aims to assess the financial consequences of out of pocket payment for ART in the South African setting and the ability of couples to financially recover. Methods: A prospective follow-up study was carried out at the Infertility Clinic of the Reproductive Medicine Unit, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town. All 135 participants from the original study were invited to participate with no exclusion criteria. A six part questionnaire, developed for the original study, was adjusted to assess recovery from out of pocket expenditure for ART. Indicators of recovery included the recuperation of savings, settlement of debt and reacquisition of sold assets. Persistence of coping strategies such as reduction in spending and additional work was also assessed. Results: A follow-up rate of 54% percent was achieved. The minimum and maximum follow up period was three and five years respectively. Nineteen percent of couples reported complete financial recovery, assessed as the recovery of savings, repayment of all debt and recovery of a sold asset. Forty percent of couples were unable to settle their debt incurred during the original study. The average amount still owed was R 7 750 (SD R5 140). At follow up, 75% of couples who had reduced expenditure to offset the original cost of ART were still reporting a reduction in expenditure while 39% were still engaged in additional work. The majority of couples reporting difficulties at the time of follow up in paying bills or for basic amenities and healthcare were from the poorest socioeconomic tertiles with 64% of all couples indicating that they were not coping financially at the time of follow up. Conclusion: This study documented a long-lasting impact of OPP for ART among all HH but especially among the poorest. Given the high prevalence of infertility, its impact on individuals, couples and communities, the associated mental, emotional and financial consequences, and existing barriers to adequate and affordable treatment should be minimised as South Africa is moving towards the implementation of a national health system. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/27549 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:48:57.826Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2018 |
| publishDateRange | 2018 |
| publishDateSort | 2018 |
| publisher | Department of Obstetrics and Gynaecology |
| publisherStr | Department of Obstetrics and Gynaecology |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/27549 Out of pocket payment for assisted reproductive techniques: How to households recover? Vinoos, Latiefa Dyer, Silke Obstetrics and Gynaecology Health Economics Introduction: The cost of ART remains amongst the most prevalent barriers to treatment, especially in resource limited countries where many people are poor and inadequately covered by private and public health insurances. This study aims to assess the financial consequences of out of pocket payment for ART in the South African setting and the ability of couples to financially recover. Methods: A prospective follow-up study was carried out at the Infertility Clinic of the Reproductive Medicine Unit, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town. All 135 participants from the original study were invited to participate with no exclusion criteria. A six part questionnaire, developed for the original study, was adjusted to assess recovery from out of pocket expenditure for ART. Indicators of recovery included the recuperation of savings, settlement of debt and reacquisition of sold assets. Persistence of coping strategies such as reduction in spending and additional work was also assessed. Results: A follow-up rate of 54% percent was achieved. The minimum and maximum follow up period was three and five years respectively. Nineteen percent of couples reported complete financial recovery, assessed as the recovery of savings, repayment of all debt and recovery of a sold asset. Forty percent of couples were unable to settle their debt incurred during the original study. The average amount still owed was R 7 750 (SD R5 140). At follow up, 75% of couples who had reduced expenditure to offset the original cost of ART were still reporting a reduction in expenditure while 39% were still engaged in additional work. The majority of couples reporting difficulties at the time of follow up in paying bills or for basic amenities and healthcare were from the poorest socioeconomic tertiles with 64% of all couples indicating that they were not coping financially at the time of follow up. Conclusion: This study documented a long-lasting impact of OPP for ART among all HH but especially among the poorest. Given the high prevalence of infertility, its impact on individuals, couples and communities, the associated mental, emotional and financial consequences, and existing barriers to adequate and affordable treatment should be minimised as South Africa is moving towards the implementation of a national health system. 2018-02-13T08:33:42Z 2018-02-13T08:33:42Z 2017 Master Thesis Masters MMed http://hdl.handle.net/11427/27549 eng application/pdf Department of Obstetrics and Gynaecology Faculty of Health Sciences University of Cape Town |
| spellingShingle | Obstetrics and Gynaecology Health Economics Vinoos, Latiefa Out of pocket payment for assisted reproductive techniques: How to households recover? |
| thesis_degree_str | Master's |
| title | Out of pocket payment for assisted reproductive techniques: How to households recover? |
| title_full | Out of pocket payment for assisted reproductive techniques: How to households recover? |
| title_fullStr | Out of pocket payment for assisted reproductive techniques: How to households recover? |
| title_full_unstemmed | Out of pocket payment for assisted reproductive techniques: How to households recover? |
| title_short | Out of pocket payment for assisted reproductive techniques: How to households recover? |
| title_sort | out of pocket payment for assisted reproductive techniques how to households recover |
| topic | Obstetrics and Gynaecology Health Economics |
| url | http://hdl.handle.net/11427/27549 |
| work_keys_str_mv | AT vinooslatiefa outofpocketpaymentforassistedreproductivetechniqueshowtohouseholdsrecover |