Kumar A, Nagpal J, Bhartia A
Sitaram Bhartia Institute of Science and Research, B-16, Qutab Institutional Area, New Delhi-110 016.
J Assoc Physicians India. 2008 Sep;56:667-74.
To estimate the direct cost of ambulatory care in diabetes patients in the middle and high income group populace of Delhi.
We analyzed the drugs, investigations, consultation and monitoring related data available from a survey of 35- 65-year-old known diabetes patients conducted using a probability-proportionate-to-size 2-stage cluster design to calculate the direct cost of ambulatory diabetes care.
A total of 819 subjects were enrolled from 20,666 houses. The average estimate of direct annual expenditure on ambulatory care of diabetes was approximately Rs. 6000 (approximately US$ 150). Time elapsed since diagnosis (p<0.001), education (p=0.011), gross family income (p=0.002), presence of co-morbidities (p=0.009) and requirement for useof oral hypoglycemic agents (p<0.001) or insulin (p<0.001) were significant correlates. Direct ambulatory cost of care comprised 1-3% of the gross family income of the subjects.
Despite the limitations of the present study it may be concluded that a majority of the diabetes patients spend a significant proportion of their family income on diabetes related expenditure. The cost is higher for subjects with longer duration since diagnosis, those with higher education or income, those with co-morbidities and those requiring oral hypoglycemic agents or insulin.
估算德里中高收入群体糖尿病患者门诊护理的直接成本。
我们分析了一项针对35至65岁已知糖尿病患者的调查中可得的药物、检查、会诊及监测相关数据，该调查采用按规模大小成比例的两阶段整群设计来计算糖尿病门诊护理的直接成本。
共从20666户家庭中纳入了819名受试者。糖尿病门诊护理的年度直接支出平均估计约为6000卢比（约合150美元）。自诊断以来的时间（p<0.001）、教育程度（p=0.011）、家庭总收入（p=0.002）、合并症的存在（p=0.009）以及使用口服降糖药（p<0.001）或胰岛素（p<0.001）的需求是显著的相关因素。护理的直接门诊成本占受试者家庭总收入的1 - 3%。
尽管本研究存在局限性，但可以得出结论，大多数糖尿病患者将其家庭收入的很大一部分用于糖尿病相关支出。对于诊断后病程较长、教育程度或收入较高、患有合并症以及需要口服降糖药或胰岛素的受试者，成本更高。
