Department of Community Medicine, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
Department of Data Sciences, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India.
WHO South East Asia J Public Health. 2021 Jul-Dec;10(2):84-89. doi: 10.4103/WHO-SEAJPH.WHO-SEAJPH_20_21.
Expenditure on diabetes mellitus is increasing worldwide and is determined by multiple factors and knowledge about these factors may help to improve patient management and reduce health-care cost. The present study aims to determine the factors influencing the expenditure incurred by patients with type 2 diabetes mellitus (T2DM). A cross-sectional survey was conducted among 809 patients with T2DM from a coastal community in Southern India. Expenditure incurred for the management of T2DM in the previous year was collected using a predesigned survey tool. Duration of disease, source of diabetes care, presence of comorbidities, hospitalization, and adherence to medications were studied as potential cost predictors. Age, gender, education, occupation, and socioeconomic status as key determinants were evaluated. Expenditure incurred by patients with T2DM was estimated to be INR 5041 (2516-11,224) annually while the presence of comorbidities led to higher expenditure, INR 9133 (4034-19,053). Medication and hospitalization were the major drivers of direct cost. Subjects visiting private health facilities had a higher median cost with respect to diabetes-related care. Advancing age, male gender, high socioeconomic status, higher literacy, and longer duration of diabetes were identified as significant independent predictors of cost on multivariate analysis. The high cost of diabetes supports the need for strengthening public and private primary care facilities to provide standard care for diabetes.
糖尿病的医疗支出在全球范围内不断增加，这取决于多种因素，了解这些因素可能有助于改善患者管理并降低医疗保健成本。本研究旨在确定影响 2 型糖尿病（T2DM）患者支出的因素。在印度南部沿海社区对 809 名 T2DM 患者进行了横断面调查。使用预先设计的调查工具收集了前一年用于 T2DM 管理的支出。研究了疾病持续时间、糖尿病护理来源、合并症存在、住院和药物依从性作为潜在的成本预测因素。评估了年龄、性别、教育、职业和社会经济地位等关键决定因素。T2DM 患者的支出估计为每年 INR5041（2516-11224），而合并症的存在导致更高的支出，INR9133（4034-19053）。药物和住院治疗是直接成本的主要驱动因素。与糖尿病相关的护理方面，私人医疗机构就诊的患者的中位数费用更高。多变量分析确定了年龄增长、男性性别、高社会经济地位、较高的文化程度和较长的糖尿病病程是费用的显著独立预测因素。糖尿病的高成本支持需要加强公共和私人初级保健设施，为糖尿病提供标准护理。
