The determinants of out-of-pocket health-care expenses for diabetes mellitus patients in India: An examination of a tertiary care government hospital in Delhi

OBJECTIVE: To assess the determinants of out-of-pocket (OOP) expenses on diabetes-related treatment incurred in patients attending outpatient clinics in a tertiary care hospital in Delhi, India. STUDY DESIGN: A cross-sectional analysis of baseline data from a quasi-experimental study was conducted o...

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Autores principales: Basu, Saurav, Garg, Suneela, Sharma, Nandini, Singh, M. Meghachandra, Garg, Sandeep, Asaria, Miqdad
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342337/
https://www.ncbi.nlm.nih.gov/pubmed/32670834
http://dx.doi.org/10.4103/picr.PICR_169_18
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author Basu, Saurav
Garg, Suneela
Sharma, Nandini
Singh, M. Meghachandra
Garg, Sandeep
Asaria, Miqdad
author_facet Basu, Saurav
Garg, Suneela
Sharma, Nandini
Singh, M. Meghachandra
Garg, Sandeep
Asaria, Miqdad
author_sort Basu, Saurav
collection PubMed
description OBJECTIVE: To assess the determinants of out-of-pocket (OOP) expenses on diabetes-related treatment incurred in patients attending outpatient clinics in a tertiary care hospital in Delhi, India. STUDY DESIGN: A cross-sectional analysis of baseline data from a quasi-experimental study was conducted over 8 months in 2016 in a major tertiary care hospital in Delhi. METHODS: The study included 375 diabetes patients up to 65 years of age on treatment for at least a year without significant complications. Data were collected through a patient interview schedule. RESULTS: Of the previous six scheduled appointments, at least two missed appointments were seen in 267 (71.2%) patients. The average patient's OOP expenditure on diabetes-related medicines was ₹63.5 a month, a similar amount was spent on traveling to and from health facilities. Sixty-four (17.1%) patients took antidiabetic medication for <85% of the days in the previous 3 months. CONCLUSION: There exists a high burden of missed clinic appointments among diabetes patients in tertiary care government health settings in India. This appears to be related to the high cost in terms of both time and money involved in attending appointments for the modest benefit of a dispensation of a 15-day drug refill. Health policy measures focused on strengthening medication coverage need to explore the balance of costs and benefits when determining the frequency of clinical appointments in these settings.
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spelling pubmed-73423372020-07-14 The determinants of out-of-pocket health-care expenses for diabetes mellitus patients in India: An examination of a tertiary care government hospital in Delhi Basu, Saurav Garg, Suneela Sharma, Nandini Singh, M. Meghachandra Garg, Sandeep Asaria, Miqdad Perspect Clin Res Original Article OBJECTIVE: To assess the determinants of out-of-pocket (OOP) expenses on diabetes-related treatment incurred in patients attending outpatient clinics in a tertiary care hospital in Delhi, India. STUDY DESIGN: A cross-sectional analysis of baseline data from a quasi-experimental study was conducted over 8 months in 2016 in a major tertiary care hospital in Delhi. METHODS: The study included 375 diabetes patients up to 65 years of age on treatment for at least a year without significant complications. Data were collected through a patient interview schedule. RESULTS: Of the previous six scheduled appointments, at least two missed appointments were seen in 267 (71.2%) patients. The average patient's OOP expenditure on diabetes-related medicines was ₹63.5 a month, a similar amount was spent on traveling to and from health facilities. Sixty-four (17.1%) patients took antidiabetic medication for <85% of the days in the previous 3 months. CONCLUSION: There exists a high burden of missed clinic appointments among diabetes patients in tertiary care government health settings in India. This appears to be related to the high cost in terms of both time and money involved in attending appointments for the modest benefit of a dispensation of a 15-day drug refill. Health policy measures focused on strengthening medication coverage need to explore the balance of costs and benefits when determining the frequency of clinical appointments in these settings. Wolters Kluwer - Medknow 2020 2020-05-06 /pmc/articles/PMC7342337/ /pubmed/32670834 http://dx.doi.org/10.4103/picr.PICR_169_18 Text en Copyright: © 2020 Perspectives in Clinical Research http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Basu, Saurav
Garg, Suneela
Sharma, Nandini
Singh, M. Meghachandra
Garg, Sandeep
Asaria, Miqdad
The determinants of out-of-pocket health-care expenses for diabetes mellitus patients in India: An examination of a tertiary care government hospital in Delhi
title The determinants of out-of-pocket health-care expenses for diabetes mellitus patients in India: An examination of a tertiary care government hospital in Delhi
title_full The determinants of out-of-pocket health-care expenses for diabetes mellitus patients in India: An examination of a tertiary care government hospital in Delhi
title_fullStr The determinants of out-of-pocket health-care expenses for diabetes mellitus patients in India: An examination of a tertiary care government hospital in Delhi
title_full_unstemmed The determinants of out-of-pocket health-care expenses for diabetes mellitus patients in India: An examination of a tertiary care government hospital in Delhi
title_short The determinants of out-of-pocket health-care expenses for diabetes mellitus patients in India: An examination of a tertiary care government hospital in Delhi
title_sort determinants of out-of-pocket health-care expenses for diabetes mellitus patients in india: an examination of a tertiary care government hospital in delhi
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7342337/
https://www.ncbi.nlm.nih.gov/pubmed/32670834
http://dx.doi.org/10.4103/picr.PICR_169_18
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