Exploring cost drivers to improve disease management: the case of type 2 diabetes at a tertiary hospital in Burundi, Africa

BACKGROUND: In Burundi, the International Diabetes Federation estimated the prevalence of diabetes mellitus (DM) as high as 2.4% in adults aged between 20 and 79 years old. Thus, the healthcare expenditure for the treatment of diabetic patients is considerably high. OBJECTIVE: This study explores the economic burden of type 2 DM and its cost drivers at a tertiary hospital in 2018. It included adult type 2 DM patients who received treatment from a tertiary hospital (Hospital Prince Regent Charles) in 2018. In this study, 81 patients were included. METHODS: Data on illness treatment and complications were collected through patient interviews and by reviewing patients’ medical and financial records. A stepwise multiple linear regression model was used to explore factors affecting the cost of type 2 diabetes mellitus. RESULTS: The average total cost per patient per year was estimated at $2621.06. The fitted cost model had an adjusted R(2) of 0.427, which explained up to 43% of the variation in the total cost. The results suggest primary cost drivers such as treatment regimen, duration of the disease, payment method, and number of complications. CONCLUSION: The findings confirm the profound economic burden of type 2 DM and the need to improve patient care and prevent disease progression. The establishment of a special clinic for patients with diabetes is recommended, as is financial support for underprivileged patients. A specific focus on cost drivers could help establish appropriate disease management programs to control the costs for type 2 diabetes patients.