Shobhana R, Rama Rao P, Lavanya A, Williams R, Vijay V, Ramachandran A
Diabetes Research Centre & M.V. Hospital for Diabetes, 4 Main Road, Royapuram, Madras, India.
Diabetes Res Clin Pract. 2000 Apr;48(1):37-42. doi: 10.1016/s0168-8227(99)00130-8.
The objective of the study was to estimate the direct costs of diabetes care to patients attending secondary care facilities in Madras, India. A total of 596 subjects were studied, at the Private Hospital for Diabetes Mellitus (PHD) (n = 422), and at the Government General Hospital (GGH) (n = 174). A simple interview schedule enabled a face to face interaction with the patients by the research investigator which elicited a frank and true response. The validity of the data collected was established by independent scrutiny of financial records in a sub sample. Payment bills for expenses of 140 subjects chosen on a random basis from the total sample of 422 PHD patients were compared with the costs reported by the subjects. There were no statistically significant differences both in the inpatient and the outpatient cases between the reported cost and actual cost. Median bill value (total costs)=Rs.1010 (range 195-16700) reported value=880 (110-20355) Z = -0.97, P = 0.33 and, for outpatients, median bill value=Rs.800 (195-4560) reported value=Rs. 740 (110-6320) Z = -1.56, P = 0.12. For inpatients, median bill value = Rs. 4235 (1289-16700) reported value=Rs.5459 (1285-20355), Z = -1.27, P5 years duration of diabetes spent more than those who had <5 years of duration; Rs.5570 (360-75200) and Rs.3220, (460-25600), respectively. All differences between these sub-groups were statistically significant. Within the ambit of economic aspects of the population in a developing country, the direct cost on diabetes health care is very high for many people.
该研究的目的是估算印度马德拉斯二级医疗机构中糖尿病患者的糖尿病护理直接成本。共对596名受试者进行了研究，其中在糖尿病私立医院（PHD）（n = 422），以及在政府综合医院（GGH）（n = 174）。一份简单的访谈提纲使研究调查员能够与患者进行面对面互动，从而得到坦诚真实的回答。通过对一个子样本的财务记录进行独立审查，确定了所收集数据的有效性。从422名PHD患者的总样本中随机选取140名受试者的费用支付账单，与受试者报告的费用进行比较。报告成本与实际成本在住院和门诊病例中均无统计学显著差异。住院病例的账单价值中位数（总成本）= 1010卢比（范围195 - 16700），报告价值 = 880卢比（110 - 20355），Z = -0.97，P = 0.33；对于门诊病例，账单价值中位数 = 800卢比（195 - 4560），报告价值 = 740卢比（110 - 6320），Z = -1.56，P = 0.12。对于住院患者，账单价值中位数 = 4235卢比（1289 - 16700），报告价值 = 5459卢比（1285 - 20355），Z = -1.27，P5年病程的糖尿病患者花费多于病程<5年的患者；分别为5570卢比（360 - 75200）和3220卢比（460 - 25600）。这些亚组之间的所有差异均具有统计学显著性。在发展中国家人群的经济层面范围内，糖尿病医疗保健的直接成本对许多人来说非常高。
