CHENNAI: Diabetics in India spend more than one-third of their income on managing the disease, according to a nation-wide study.

The study established that people are spending as much at 34 per cent of their income — up from 24.5 per cent in 1998 — on diabetes care.

The data in Diabetes Care, Volume 30, February 2007, shows that on an average, the expenditure of an urban family (with diabetes) on healthcare was Rs. 10,000, while a rural family spent proportionately more (income-wise) at Rs.6260.

Treatment costs

The treatment costs increased with duration of the disease, complications, hospitalisation, surgery, insulin therapy and in urban settings.

"These figures indicate the direct health cost burden that families have to bear," says A. Ramachandran, director, Diabetes Research Centre, M.V. Hospital for Diabetes.

Direct costs include paying for drugs, hospital stay, lab tests, doctor's fees and travel. There are also added indirect costs, caused by absence from work, loss of pay and productivity.

The lack of medical insurance and the seeming distrust that patients seem to have with public healthcare systems keep shooting up the costs.

"We have even accounted for inflation. Despite that, there has been a rise of nearly 10 percentage points in costs incurred by patients since 1998," he says.

The aim of the study was to demonstrate the "rising prevalence of Type 2 Diabetes and the major clinical, economic and society burden" it causes on the country.

The problem also lies in the way the country is approaching the disease, Dr. Ramachandran says.

The study sample consisted of 556 diabetics from various urban and rural regions of seven States and data was collected for one month in 2005.

Urban subjects spent a significantly higher amount on medications, laboratory tests and medical consultation and surgery than those in rural areas.

The proportion of income that urban low-income groups spend on diabetes care was much higher - 34 per cent; the middle class spent 16.9 per cent; upper middle class 9.3 per cent; and high income group, 4.8 per cent.

Clearly expenses rose when a patient lives with diabetes for a longer while. For instance, a patient living with diabetes for over five years spends 11.5 per cent of his or her income on tending to his disease.

Hospitalisation

Of this, a substantial amount — Rs.5,000 is spent on hospitalisation and following close on it heels is the amount spent on out patient medical care — Rs. 4,885.

The National Health Accounts of India, published in December 2005, indicates that the major financing sources in the healthcare system are households, which account for 72 per cent of the total health expenditure incurred.

This includes out of pocket payments borne by the households for treating illness among any member in the household and also insurance premium contributed by individuals for enrolling themselves or family members in various social voluntary health insurance schemes.

The government provided only 19 per cent (Centre and State combined).

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