Economic burden of diabetes care in a tertiary care hospital-based population: A prospective observational study

Abstract

Background: Type 2 diabetes mellitus (T2DM) is worldwide burdensome disease. However, direct, and indirect costs data of its management and care is urgent need.

Objective: The aim of this prospective tertiary care study was to assess the total direct and indirect cost with long-term diabetes care in tertiary care.

Methods: A total of 320 participants with T2DM fulfilling the American Diabetes Association screening and diagnostic guidelines recruited for cost assessment. Group I (n=160) was given education and empowerment along with standard care of treatment while other group II (n=160) received only standard care treatment. Direct and indirect cost including the medication, laboratory investigations, specialized treatment cost, leaves absentee and travel cost recorded in both groups and were followed 4 times in a year up to duration of 1 year.

Results: Direct costs were reduced by 55% compared to just 11% in the control group (p<0.001), with medication costs showed decrease of 89.9% versus 31.5% in controls (p<0.001). Importantly, these substantial cost reductions were achieved while maintaining equivalent glycaemic control, with nearly identical HbA1c levels between groups (7.69% vs 7.68%; p=0.886). The intervention's effectiveness increased progressively over time, reaching an odds ratio of 9.75 for cost reduction at 24 months (p<0.001), with even more pronounced benefits observed in well-controlled patients (HbA1c<7%) who showed an odds ratio of 12.5 for cost reduction.

Conclusions: The findings reveal that education and empowerment hold promise for cutting diabetes-related costs significantly without sacrificing quality, showcasing their relevance for healthcare strategies and resource allocation in managing chronic conditions.