ORIGINAL STUDY Table 1. Distribution of Study Population according to the Amount Spent on Treatment per Month in the Past One Year Details of expenditure Consultation
Investigations
Medication
Expenditure in rupees
No. of patients
Percentage (%)
<100
82
63.08
100-300
37
23.46
>300
11
8.46
<200
106
81.54
200-500
15
11.54
>500
09
6.92
<2,500
93
71.54
2,500-5,000
29
22.31
>5,000
08
6.15
with 1-3 years duration. In the present study majority (63.08%) of the participants had no complications and 36.92% diabetics had complications. Among them 26.15% had hypertension, 16.15% had neuropathy, 11.54% had retinopathy, 9.23% had heart disease and 6.15% had nephropathy (Fig. 3). In the present study majority (90.77%) of the patients followed allopathic treatment regimen followed by 6.92% who had ayurvedic and 2.31% who had homeopathic medicine. In this study, 9.23% diabetics required admission for the treatment of diabetes during the last one year. In this study, majority of the diabetics (40.77%) had single consultation in the past one year followed by no consultation (27.69%) and twice (20.77%). However, 10.77% of the diabetics had more than two consultations in the past one year. In this study, most of the diabetics (60.77%) spent half day for the consultation to the doctor followed by one day (36.15%) and more than one day (3.08%). In this study, with regard to consultation costs most of the diabetics (63.08%) spent less than ` 100 followed by ` 100-300 (23.46%) and more than ` 300 (8.46%). The investigations during the past one year amounted to less than ` 200 among 81.54%, ` 200-500 among 11.54% and more than ` 500 among 6.92% diabetics. The cost of medication was less than ` 2,500 in 71.54% cases, ` 2,500-5,000 among 22.31% and more than ` 5,000 among 6.15% diabetics (Table 1). In this study majority of the diabetics (55.38%) skipped laboratory investigations due to the cost followed by consultation (17.69%) and medication (3.08%).
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Study population
Asian Journal of Diabetology, Vol. 16, No.1, January-March 2013
In this study most of the diabetics (55.08%) financed their own treatment followed relatives (33.08%), health insurance (10.77%) and loan (3.08%). DISCUSSION Healthcare delivery in India is provided either by doctors in the health centers, clinics, district, municipal and tertiary teaching hospitals run by the central and state governments; or through private practicing general practitioners, specialists in their clinics, nursing homes or large corporate hospitals. The quality and cost of care varies considerably from place-to-place, depending on the available resources, training and interest in diabetes of the treating doctor and the patientsâ&#x20AC;&#x2122; ability to pay for it. Generally, care provided in government institutions is free or at low subsidized cost. These institutions are crowded, ill-equipped and have scant resources. Those seeking medical care in the private sector pay for everything on their own, as there is limited or no reimbursements. When uniformly good quality care is accessible to all, the disease outcome is at least not predetermined by his/her socioeconomic status.2 The Bangalore Urban District (BUD) Diabetes Study estimated the annual direct cost for routine care in Bangalore, India, in 1998 to be about 191 US dollars, the mean direct cost per hospitalization for a diabetes related episode was about 208 US dollars. Health resources in India and other developing countries are very limited with only 5% of GDP, (USD 23 per capita) being spent on healthcare. With regard to the occupation most of the diabetics were self-employed (44.62%) followed by 36.92% with other occupation predominantly house wife, 14.62% with office job and 3.85% were unemployed. In this