Out-of-pocket expenditure and drug adherence of patients with diabetes in Odisha

Sarit Kumar Rout · SwagatikaPriyadarshini Swain · Sudipta Samal · Kirti Sundar Sahu

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Abstract

INTRODUCTION: The burden of diabetes mellitus (DM) is increasing in India and across states. Given the chronic and progressive nature of the disease, it implicates huge financial burden on patients. Given this, the objectives of this study are to estimate the out-of-pocket (OOP) expenditure on diabetes care and assess the magnitude of medication adherence among patients in a public hospital. MATERIALS AND METHODS: A cross-sectional survey was conducted among 206 patients with age ≥25 years visiting the outpatient department of a tertiary care hospital in Odisha. Cost data were collected from April to June 2016 using a structured questionnaire, and drug adherence was assessed using the Morisky Medication Adherence Scale. RESULTS: The average total expenditure per patient per month was INR 1265 (95% confidence interval 1178-1351), of which medical expenditure was INR 993 (95 confidence interval 912-1075) and that of nonmedical expenditure was INR 271 (95 confidence interval 251-292). Expenditure on medicine constituted around 65% of total medical expenditure. The other drivers of medical expenditure were diagnostics services constituting 13.2% and transportation (11.8%). Overall, only 15% of the patients reported high adherence to medication. DISCUSSION: This study generated evidence on OOP expenditure on diabetics in Odisha which are comparable to many Indian studies. One of the critical findings of this study was that a majority of patients visiting public hospitals had to spend OOP on medicine and diagnostic services. These findings could be used to design appropriate financing strategies to protect the interest of the poor who largely use public health facility in Odisha.

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2007Increasing Expenditure on Health Care Incurred by Diabetic Subjects in a Developing Country 2014The economic burden of diabetes in India: a review of the literature 2011Cost-of-Illness Analysis of Type 2 Diabetes Mellitus in Iran 2013The costs of treating long-term diabetic complications in a developing country: a study from India.2009Household economic impact of an emerging disease in terms of catastrophic out-of-pocket health care expenditure and loss of productivity: investigation of an outbreak of chikungunya in Orissa, India.2014Economic Burden of Diabetes in Urban Indians

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