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Cost of diabetes treatment in private facilities for low resource urban community in South India

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Background and aim

Diabetes has become a public health threat. The cost of diabetes care varies in different communities and depends on health-seeking behavior and socio-economic condition of the people. Data on economic and social impact of diabetes treatment among socially weaker section is scanty. Hence, this study was conducted to estimate the direct and indirect cost of treating diabetes among people living in low resource urban setting.

Methods

A cross-sectional study was conducted among 1065 households in the two selected areas of North Chennai. Data was collected from individuals who were taking diabetes treatment in private health care facilities. The cost toward diabetes treatment for each participant was calculated using their medical bills, tablet strips and also self-reported cost details.

Results

A total of 341 individuals were found to have diabetes and out of them, 230 (M:F, 63:167) individuals who attended private health facilities for their diabetes treatment were studied. Around 73% of them earned a monthly income of < INR 10,000. The study revealed that median annual direct cost of treating diabetes among the study participants was amounted to INR 7540. Annual median indirect cost amounted to INR 1650.

Conclusion

People living with diabetes in low resource urban setting spent more toward direct medical cost. The out of pocket expenditure was mainly on hospitalization followed by medicines and investigations. The strengthening and provision of appropriate primary public health care services for diabetes in this setting may reduce out of pocket expenditure toward treatment of diabetes in private health care facilities.

Highlights

• Nearly 3/4th of study participants who earn INR 10,000/month monitor their diabetes status rarely, but take medicines alone.

• They spend INR 6000 on medicines annually while they spend only INR 400 on lab investigations.

• More than 1/4th (28.3%) of them were irregular in taking medication and buying medicines with previous tablet strips from the medical shop.

• Hypertension (24.7%) was the most common co-morbid condition prevalent among them than any other diabetic complications.

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References

  1. Khan MAB, Hashim MJ, King JK, Govender RD, Mustafa H, Al KJ. Epidemiology of Type 2 Diabetes - Global Burden of disease and Forecasted trends. J Epidemiol Glob Health. 2020;10(1):107–11. https://doi.org/10.2991/jegh.k.191028.001. PMID: 32175717; PMCID: PMC7310804

  2. World Health Organization. Geneva: Global report on diabetes 2016. http://apps.who.int/iris/bitstream/10665/204871/1/9789241565257_eng.pdf. Accessed 10 September 2019.

  3. World Health Organization. Geneva. Global status report on non-communicable diseases. 2014. https://apps.who.int/iris/bitstream/handle/10665/148114/9789241564854_eng.pdf Accessed 12 July 2019

  4. International Diabetes Federation [Internet]. Belgium: IDF- Diabetes Atlas 7th edition 2015. https://www.idf.org/e-library/epidemiology-research/diabetes-atlas/13-diabetes-atlas-seventh-edition.html. Accessed 06 December 2019.

  5. International Diabetes Federation [Internet]. Prevalence of Diabetes in India. https://diabetesatlas.org/upload/resources/material/20200302_133351_IDFATLAS9e-final-web.pdf. Accessed 08 February 2020.

  6. World Health Organization [Internet]. India: World Health Day Report- 2016. http://www.searo.who.int/india/mediacentre/events/world_health_day/brief_note_on_diabetes_in_india-6april.pdf?ua=1. Accessed 02 August 2019.

  7. Bloom DE, Cafiero-Fonseca ET, Candeias V, Adashi E, Bloom L, Gurfein L, et al. Economics of non-communicable diseases in India: the costs and returns on investment of interventions to promote healthy living and prevent, treat, and manage NCDs. World Economic Forum, Harvard School of Public Health, 2014. http://www3.weforum.org/docs/WEF_EconomicNonCommunicableDiseasesIndia_Report_2014.pdf. Accessed 10 April 2020.

  8. Anjana RM, Deepa M, Pradeepa R, Jagadish M, Kanwar N, Das HK, et al. Prevalence of diabetes and prediabetes in 15 states of India: results from the ICMR–INDIAB population-based cross-sectional study. Lancet Diabetes Endocrinol. 2017;5(8):585–96. https://doi.org/10.1016/S2213-8587(17)30174-2. Epub 2017 Jun 7. Erratum in: Lancet Diabetes Endocrinol. 2017;5(8):e5

    Article  PubMed  Google Scholar 

  9. Vigneswari A, Manikandan R, Satyavani K, Archana S, Rajeswari R, Viswanathan V. Prevalence of risk factors of diabetes among urban poor south Indian population. JAPI. 2015;63(10):32–3.

    CAS  PubMed  Google Scholar 

  10. Slums in Chennai increased by 50% in a single decade, Times of India, January 18, 2016 <https://timesofindia.indiatimes.com/city/chennai/slums-in-chennai-increase-by-50-in-a-single-decade/articleshow/50618951.cms>. Accessed 19 July 2020.

  11. Oberoi S, Kansra P. Economic menace of diabetes in India: a systematic review. Int J Diabetes Dev Ctries. 2020;40:464–75. https://doi.org/10.1007/s13410-020-00838-z.

  12. Tharkar S, Satyavani K, Viswanathan V. Cost of medical care among type 2 diabetic patients with a co-morbid condition -hypertension in India. Diabetes Res Clin Pract. 2009;83(2):263–7. https://doi.org/10.1016/j.diabres.2008.11.027.

    Article  PubMed  Google Scholar 

  13. Kapur A. Economic analysis of diabetes care. World Diabetes Foundation, Lyngby, Denmark. Indian J Med Res. 2007;125(3):473–82.

    PubMed  Google Scholar 

  14. Tharkar S, Devarajan A, Kumpatla S, Viswanathan V. The socioeconomics of diabetes from a developing country: A population based cost of illness study. Diabetes Res Clin Pract. 2010;89(3):334–40. https://doi.org/10.1016/j.diabres.2010.05.009.

    Article  PubMed  Google Scholar 

  15. Ramachandran A, Ramachandran S, Snehalatha C, Augustine C, Murugesan N, Viswanathan V. Increasing expenditure on health care incurred by diabetic subjects in a developing country. Diabetes Care. 2007;30(2):252–6. https://doi.org/10.2337/dc06-0144.

    Article  PubMed  Google Scholar 

  16. Javalkar SR. The economic burden of health expenditure on diabetes mellitus among urban poor: a cross sectional study. Int J Community Med Public Health. 2019;6:1162–6. https://doi.org/10.18203/2394-6040.ijcmph20190604.

    Article  Google Scholar 

  17. Fernandes SD, Fernandes SDA. Economic burden of diabetes mellitus and its socio- economic impact on household expenditure in an urban slum area. Int J Res Med Sci. 2017;5(5):1808–13. https://doi.org/10.18203/2320-6012.ijrms20171585.

    Article  Google Scholar 

  18. Eshwari K, Kamath VG, Rao CR, Kamath A. Annual cost incurred for the management of type 2 diabetes mellitus—a community-based study from coastal Karnataka. Int J Diabetes Dev Ctries. 2019;39(3):590–5. https://doi.org/10.1007/s13410-018-0691-5.

    Article  Google Scholar 

  19. Sharma KM, Ranjani H, Zabetian A, Datta M, Deepa M, Moses CRA, Narayan KMV, Mohan V, Ali MK. Excess cost burden of diabetes in Southern India: a clinic-based, comparative cost-of-illness study. Glob Health Epidemiol Genom. 2016;1:e8. https://doi.org/10.1017/gheg.2016.2.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Loganathan ACV, John KR. Economic burden of diabetes in people living with the disease: a field study. J Diabetology. 2013;4(3):1–8.

    Google Scholar 

  21. Jitendra S. Economic burden of Diabetes. Medicine Update. 2015:1-4. http://apiindia.org/wp-content/uploads/medicine_update_2013/chap45.pdf. Accessed 4 April 2021.

  22. Banerjee A, Bhawalkar JS, Jadhav SL, Rathod H, Khedkar DT. Access to health services among slum dwellers in an industrial township and surrounding rural areas: a rapid epidemiological assessment. J Family Med Prim Care. 2012;1(1):20–6. https://doi.org/10.4103/2249-4863.94444.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Singh S, Kalaskar S. Health care seeking behavior and utilization pattern in an urban slum of Mumbai: A cross sectional study. Int J Curr Res. 2017;9(4):49342–5.

    Google Scholar 

  24. Tharkar S, Devarajan A, Barman H, Mahesh U, Viswanathan V. How far has translation of research been implemented into clinical practice in India? Are the recommended guidelines adhered to? Int J Diabetes Mellit. 20154;3(1):25–30. https://doi.org/10.1016/j.diabres.2010.05.009. Epub 2010 Jun 9

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Acknowledgments

We thank our epidemiology team members for data collection and entry. We are indebted to all our study participants who were willing to spend their valuable time for the interview process.

Funding

This study did not receive any fund from external sources.

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Authors and Affiliations

  1. Department of Epidemiology, Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research, Education and Training in Diabetes) (IDF Centre of Excellence in Diabetes Care), Royapuram, Chennai, 600013, India

    Anu Maria Jacob, Arutselvi Devarajan, Sukanya Nachimuthu & Manjula Datta

  2. M.V. Hospital for Diabetes & Prof. M. Viswanathan Diabetes Research Centre (WHO Collaborating Centre for Research, Education and Training in Diabetes) (IDF Centre of Excellence in Diabetes Care), Royapuram, Chennai, 600013, India

    Vijay Viswanathan

Authors
  1. Anu Maria Jacob
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  2. Arutselvi Devarajan
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  3. Sukanya Nachimuthu
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  4. Manjula Datta
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  5. Vijay Viswanathan
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Corresponding author

Correspondence to Vijay Viswanathan.

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The authors declare no conflict of interest.

Informed Consent

Ethical clearance was taken from the Institutional Ethics Committee (EC. No.: IEC/N-001/IN/03/2017) and a written informed consent was obtained from each participant before starting the study.

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Jacob, A.M., Devarajan, A., Nachimuthu, S. et al. Cost of diabetes treatment in private facilities for low resource urban community in South India. Int J Diabetes Dev Ctries 43, 208–213 (2023). https://doi.org/10.1007/s13410-022-01047-6

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  • DOI: https://doi.org/10.1007/s13410-022-01047-6

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