Direct cost of ambulatory care of type 2 diabetes in the middle and high income group populace of Delhi: the DEDICOM survey.

Objective: To estimate the direct cost of ambulatory care in diabetes patients in the middle and high income group populace of Delhi.

Research Design And Methods: We analyzed the drugs, investigations, consultation and monitoring related data available from a survey of 35- 65-year-old known diabetes patients conducted using a probability-proportionate-to-size 2-stage cluster design to calculate the direct cost of ambulatory diabetes care.

Results: A total of 819 subjects were enrolled from 20,666 houses. The average estimate of direct annual expenditure on ambulatory care of diabetes was approximately Rs. 6000 (approximately US$ 150). Time elapsed since diagnosis (p<0.001), education (p=0.011), gross family income (p=0.002), presence of co-morbidities (p=0.009) and requirement for useof oral hypoglycemic agents (p<0.001) or insulin (p<0.001) were significant correlates. Direct ambulatory cost of care comprised 1-3% of the gross family income of the subjects.

Conclusion: Despite the limitations of the present study it may be concluded that a majority of the diabetes patients spend a significant proportion of their family income on diabetes related expenditure. The cost is higher for subjects with longer duration since diagnosis, those with higher education or income, those with co-morbidities and those requiring oral hypoglycemic agents or insulin.