Out of pocket payment for diabetes mellitus in a public hospital of Karachi.

OBJECTIVE: To estimate the out-of-pocket payment on routine management of type 2 diabetes in patients attending a public-sector facility.

METHODS: The cross-sectional study was conducted from December 2016 to May 2017 at Jinnah Postgraduate Medical Centre, Karachi, and comprised of persons with type 2 diabeties. A pretested questionnaire was administered to collect data from the patients. Comparisons of average out-of-pocket expenditure were done across different groups on the basis of gender, education, monthly income and duration of disease. SPSS 20 was used for data analysis.

RESULTS: Of the 336 subjects, 178(53%) were males and 158(47%) were females. Overall mean age was 52.20+/-12.64 years, and 170(50.6%) were illiterate. The monthly mean cost on diabetes care was PKR2227}2217.70. People with academic level matriculation or higher spent more on the disease (p<0.001). Expenditure increased with the increase in number of years of disease (p<0.001). Participants with income of less than PKR15000 spent higher percentage of their income compared to the participants earning more (p<0.001).

CONCLUSIONS: High out-of-pocket expenditure was incurred by people with diabeties. The coverage of social security nets and individual insurance should be broadened to help improve diabetes management.