PMID- 27586208
OWN - NLM
STAT- MEDLINE
DCOM- 20180112
LR  - 20220408
IS  - 0970-258X (Print)
IS  - 0970-258X (Linking)
VI  - 29
IP  - 2
DP  - 2016 Mar-Apr
TI  - High direct costs of medical care in patients with Type 1 diabetes attending a 
      referral clinic in a government-funded hospital in Northern India.
PG  - 64-7
AB  - BACKGROUND: There is little information regarding costs of managing type 1 
      diabetes mellitus (T1DM) from low- and middle-income countries. We estimated 
      direct costs of T1DM in patients attending a referral diabetes clinic in a 
      governmentfunded hospital in northern India. METHODS: We prospectively enrolled 
      88 consecutive T1DM patients (mean [SD] age 15.3 [8] years) with age at onset <18 
      years presenting to the endocrine clinic of our institution. Data on direct costs 
      were collected for a 12 months-6 months retrospectively followed by 6 months 
      prospectively. RESULTS: Patients belonged predominantly (77%) to the middle 
      socioeconomic strata (SES); 81% had no access to government subsidy or health 
      insurance. The mean direct cost per patient-year of T1DM was ;27 915 
      (inter-quartile range [IQR] ;19 852-32 856), which was 18.6% (7.1%-30.1%) of the 
      total family income. A greater proportion of income was spent by families of 
      lower compared to middle SES (32.6% v. 6.6%, p<0.001). The mean out-of-pocket 
      payment for diabetes care ranged from 2% to 100% (mean 87%) of the total costs. 
      The largest expenditure was on home blood glucose monitoring (40%) and insulin 
      (39.5%). On multivariate analysis, total direct cost was associated with annual 
      family income (beta=0.223, p=0.033), frequency of home blood glucose monitoring 
      (beta=0.249, p=0.016) and use of analogue insulin (beta=0.225, p=0.016). CONCLUSIONS: 
      Direct costs of T1DM were high; in proportion to their income the costs were 
      greater in the lower SES. The largest expenditure was on home blood glucose 
      monitoring and insulin. Support for insulin and glucose testing strips for T1DM 
      care is urgently required.
FAU - Katam, Kishore K
AU  - Katam KK
AD  - Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, Uttar Pradesh, India.
FAU - Bhatia, Vijayalakshmi
AU  - Bhatia V
AD  - Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, Uttar Pradesh, India.
FAU - Dabadghao, Preeti
AU  - Dabadghao P
AD  - Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, Uttar Pradesh, India.
FAU - Bhatia, Eesh
AU  - Bhatia E
AD  - Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical 
      Sciences, Lucknow 226014, Uttar Pradesh, India.
LA  - eng
PT  - Journal Article
PL  - India
TA  - Natl Med J India
JT  - The National medical journal of India
JID - 8809315
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Ambulatory Care Facilities
MH  - Child
MH  - Child, Preschool
MH  - Cost of Illness
MH  - Diabetes Mellitus, Type 1/*economics/*epidemiology/therapy
MH  - Female
MH  - Health Care Costs/*statistics & numerical data
MH  - Hospitals, Public
MH  - Humans
MH  - India/epidemiology
MH  - Male
MH  - Prospective Studies
MH  - Referral and Consultation
MH  - *Social Class
MH  - Young Adult
EDAT- 2016/09/03 06:00
MHDA- 2018/01/13 06:00
CRDT- 2016/09/03 06:00
PHST- 2016/09/03 06:00 [entrez]
PHST- 2016/09/03 06:00 [pubmed]
PHST- 2018/01/13 06:00 [medline]
AID - NatlMedJIndia_2016_29_2_64_188671 [pii]
PST - ppublish
SO  - Natl Med J India. 2016 Mar-Apr;29(2):64-7.