Increasing Expenditure on Health Care Incurred by Diabetic Subjects in a Developing Country: A study from India

Epidemiology/Health Services/Psychosocial Research

Increasing Expenditure on Health Care Incurred by Diabetic Subjects in a Developing Country

¹Diabetes Research Centre, M.V. Hospital for Diabetes, World Health Organization Collaborating Centre for Research, Education and Training in Diabetes, Royapuram, Chennai, India
²School of Medicine, University of Wales Swansea, Swansea, U.K.

Address correspondence and reprint requests to Prof. Ambady Ramachandran, MD, PhD, DSc, FRCP(Lond) (Edin), Director, Diabetes Research Centre, M.V. Hospital for Diabetes, WHO Collaborating Centre for Research, Education and Training in Diabetes, 4 Main Rd., Royapuram, Chennai 600 013, India. E-mail: ramachandran{at}vsnl.com

Diabetes Care 2007 Feb; 30(2): 252-256. https://doi.org/10.2337/dc06-0144

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Figure 1—
Expenditure incurred by urban and rural subjects in relation to the number of complications. The x-axis shows the prevalence of complications, and the y-axis shows the expenditure incurred in Indian Rs.
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Figure 2—
Change in the proportion of income spent on diabetes by different income groups between the 1998 and 2005 in the urban population. The x-axis shows the income group, and y-axis shows the percentages of income spent. The low-income group showed the highest increase (34% in 2005 vs. 24.5% in 1998, P < 0.01). a, χ² = −7.25, P = 0.007; b, χ² = −16.94, P < 0.0001; c, χ² = −10.34, P < 0.001; d, χ² = −3.01, P = 0.08.

Table 1—

ographic data of diabetic subjects

Variables	Urban	Rural	P value
Sex
Male	194 (62.8)	147 (59.5)
Female	115 (37.2)	100 (40.5)
Age (years)	56.2 ± 10.5	54.8 ± 11.8
Education
Illiterate	5 (1.6)	17 (6.9)	0.003
Elementary	92 (30)	144 (58.3)	0.001
Higher secondary	72 (23.4)	58 (23.4)	0.959
Graduation	84 (27.4)	14 (5.7)	0.001
Post graduation	54 (17.6)	14 (5.7)	0.001
Employment status
Not employed	31 (10.6)	30 (12.3)	0.511
Housewife	93 (31.6)	94 (38.6)	0.059
Clerical	8 (2.7)	4 (1.6)	0.625
Management	70 (23.8)	42 (17.2)	0.122
Professional	50 (17)	53 (21.7)	0.138
Non-professional	11 (3.7)	19 (7.8)	0.050
Retired	31 (10.6)	2 (0.8)	0.001
Income status (Rs)*
<40,000	47 (15.2)	124 (50.2)	0.001
40,000–80,000	92 (29.7)	75 (30.3)	0.95
80,000–120,000	62 (20)	27 (10.9)	0.005
>120,000	108 (34.9)	21 (8.5)	0.001
Duration of diabetes (years)	10.4 ± 7.1	7.5 ± 5.5	0.001

Table 2—

Income and treatment expenses of the diabetic subjects

Variables	Urban	Rural	P value
n	309	247
Annual family income	100,000 (10,000–1,000,000)	36,000 (10,000–300,000)	0.001
	$2,272 (227–22,727)	$818 (227–6,818)
Expenditure on medications	4,000 (300–70,000)	2,500 (100–50,000)	0.001
Laboratory tests	1,500 (50–15,000)	500 (30–30,000)	0.001
Medical consultations	1,000 (30–22,000)	600 (30–30,000)	0.005
Expenditure on hospitalization	10,000 (350–150,000)	6,000 (300–75,000)	0.07
Expenditure on surgery	21,000 (2,000–180,000)	6,500 (500–90,000)	0.087
Total median expenditure	10,000 (1,000–319,000)	6,260 (1,000–125,000)	0.001
	$227 (23–7,250)	$142 (23–2,840)

Data are median (range) in Indian Rs unless otherwise stated. Rs 44 = $1.00 (approximately).

Table 3—

Comparison of treatment expenses of the urban sample of diabetic subjects between 1998 and 2005 after accounting for inflation

Variables	1998 (Rs)	2005 (Rs)	P value	Increases (%)
Expenditure on medications	2,560	3,571	<0.0001	39.5
Laboratory tests	307	1,339	<0.0001	336.2
Medical consultations	299	893	<0.0001	198.7
Expenditure on hospitalization	4,267	8,929	0.0002	109.3
Expenditure on surgery	2,560	18,750	0.0003	632.4
Median expenditure	4,194 (871–64,182)	8,930 (893–284,821)	<0.0001	112.9
	$95 (20–1,459)	$203 (20–6,473)