A Cross-Sectional study to Assess the Out-Of-Pocket Expenditure on Diabetes Mellitus among the Urban Population of Thoothukudi District, Tamilnadu, India – 2016

BACKGROUND: The prevalence of diabetes is ever increasing in India. Diabetes is a life-long commitment both to the patient and to the provider. Diabetics are at higher risk of developing micro vascular and macro vascular complications and other comorbidities than non-diabetics. Healthcare cost of diabetes is also high since it requires close monitoring to prevent dangerous complications that may further increase the healthcare cost. Majority of healthcare cost in India is out-of-pocket. In addition to direct cost, indirect cost is also high resulting in reduced productivity to the employer / government. AIM OF THE STUDY: To assess the out-of-pocket expenditure on diabetes among the people with diabetes mellitus in urban Tamilnadu. METHODOLOGY: A community-based cross-sectional study was conducted among the diabetic patients in Thoothukudi Corporation. Study tool used as semi-structured interview based questionnaire. Multistage sampling was used to select the study participants. A sample of 180 diabetic individuals were interviewed regarding their medical and expenditure details for the past three months. RESULTS: The median quarterly OOPE for the study population was ₹ 1710 with an interquartile range of ₹ 2958. Lower-income group people spent a larger proportion of their income on diabetes. Male gender, higher education and socio-economic status, economical dependency, presence of co-morbidities and complications and hospitalization were significantly associated with increased OOPE on diabetes. The most common coping mechanism for the study population when the healthcare expenditure increased for the study population was personal savings. CONCLUSION: Healthcare professionals and the community should be aware of the factors that drives the cost of diabetes. Effective intervention should be done at all levels to diagnose the disease early so that occurrence of complications is delayed, thus reducing the household financial burden