Ramachandran Ambady, Ramachandran Shobhana, Snehalatha Chamukuttan, Augustine Christina, Murugesan Narayanasamy, Viswanathan Vijay, Kapur Anil, Williams Rhys
Diabetes Research Centre, M.V. Hospital for Diabetes, WHO Collaborating Centre for Research, Education and Training in Diabetes, 4 Main Road, Royapuram, Chennai 600 013, India.
Diabetes Care. 2007 Feb;30(2):252-6. doi: 10.2337/dc06-0144.
This study aimed to assess the direct cost incurred by diabetic subjects who were in different income groups in urban and rural India, as well as to examine the changing trends of costs in the urban setting from 1998 to 2005.
A total of 556 diabetic subjects from various urban and rural regions of seven Indian states were enrolled. A brief uniform coded questionnaire (24 items) on direct cost was used.
Annual family income was higher in urban subjects (rupees [Rs] 100,000 or $2,273) than in the rural subjects (Rs 36,000 or $818) (P < 0.001). Total median expenditure on health care was Rs 10,000 ($227) in urban and Rs 6,260 ($142) in rural (P < 0.001) subjects. Treatment costs increased with duration of diabetes, presence of complications, hospitalization, surgery, insulin therapy, and urban setting. Lower-income groups spent a higher proportion of their income on diabetes care (urban poor 34% and rural poor 27%). After accounting for inflation, a secular increase of 113% was observed in the total expenses between 1998 and 2005 in the urban population. The highest increase in percentage of household income devoted to diabetes care was in the lowest economic group (34% of income in 1998 vs. 24.5% in 2005) (P < 0.01). There was a significant improvement in urban subjects in medical reimbursement from 2% (1998) to 21.3% (2005).
Urban and rural diabetic subjects spend a large percentage of income on diabetes management. The economic burden on urban families in developing countries is rising, and the total direct cost has doubled from 1998 to 2005.
本研究旨在评估印度城乡不同收入群体的糖尿病患者所产生的直接成本，并研究1998年至2005年城市地区成本的变化趋势。
招募了来自印度七个邦不同城乡地区的556名糖尿病患者。使用了一份简短的统一编码的直接成本调查问卷（24项）。
城市患者的家庭年收入（100,000卢比或2,273美元）高于农村患者（36,000卢比或818美元）（P<0.001）。城市患者的医疗保健总中位数支出为10,000卢比（227美元），农村患者为6,260卢比（142美元）（P<0.001）。治疗成本随着糖尿病病程、并发症的存在、住院、手术、胰岛素治疗以及城市环境而增加。低收入群体在糖尿病护理上花费的收入比例更高（城市贫困人口为34%，农村贫困人口为27%）。在考虑通货膨胀因素后，1998年至2005年城市人口的总费用出现了113%的长期增长。用于糖尿病护理的家庭收入百分比增长最高的是经济最低的群体（1998年占收入的34%，2005年为24.5%）（P<0.01）。城市患者的医疗报销从1998年的2%显著提高到2005年的21.3%。
城乡糖尿病患者在糖尿病管理上花费了很大比例的收入。发展中国家城市家庭的经济负担正在上升，总直接成本从1998年到2005年翻了一番。
