Comparative Statistical Analysis of Health Expenditure Across Public and Private Hospitals in Imo State

Healthcare financing patterns differ substantially between public and private hospitals in Imo State, South East Nigeria, with implications for household out-of-pocket expenditure burden and health service utilisation equity that require statistical quantification. This study compares statistical patterns of health expenditure among patients at public and private hospitals in Imo State. Exit interviews with 240 patients (120 from each sector) at hospitals in Owerri Municipal, Orlu, and Okigwe collected data on consultation fees, drug costs, diagnostic test costs, and total out-of-pocket expenditure. Descriptive statistics characterised expenditure distributions by sector. Independent samples t-tests compared mean expenditure between sectors, and the Mann-Whitney U test was applied for non-normally distributed expenditure variables. Levene's test confirmed unequal variances, necessitating Welch's t-test corrections. Mean total out-of-pocket expenditure was significantly higher at private hospitals (mean N18,420) than public hospitals (mean N6,340) (Welch's t = 14.8, p < 0.001). Drug cost constituted 54 percent of total expenditure at public hospitals compared to 38 percent at private facilities. Diagnostic costs were proportionally higher at private hospitals. Expenditure was positively skewed in both sectors. The study provides sector-comparative expenditure data relevant to Imo State health financing policy and recommends expansion of the National Health Insurance Authority scheme to reduce out-of-pocket expenditure burdens across both hospital sectors. Keywords: health expenditure, public private hospital, out-of-pocket costs, Imo State, comparative statistics