Cost estimation of diabetic clinic attendance at the General Hospital, Kandy, Sri Lanka

Presenter: Suneth Agampodi

Abstract

Background
The global diabetes epidemic has devastating human, social and economic effect. Study of the economic burden created by diabetes on households and health care system is useful in health planning. The purpose of the present study was to estimate the economic burden incurred upon the health care system and family by diabetic clinic patients at the General Hospital Kandy, Sri Lanka.

Methods
A descriptive cross-sectional study was conducted in Endocrinology clinic unit of General Hospital Kandy. Study sample consisted of diabetic clinic attendants and was selected using stratified systematic sampling during the months of August to September 2007. Data were collected using a pre-tested interviewer administered structured questionnaire and a check-list. Direct and indirect fixed costs and Indirect Variable Cost (IVC) were calculated for the diabetic clinic and the Direct Variable Cost (DVC) was calculated for individual patients.

Results
The study sample consists of 406 patients (Males-121/Females-285) with a mean age of 55 years (SD= 10). The estimated annual hospital cost for a diabetic clinic patient was $67.9. Hospital DVC was $54.3 out of which 78% was for pharmaceuticals. Direct hospital fixed cost for a patient was Rs. $9.3 and it was 14.33% of total hospital cost for a diabetic clinic patient. Staff salaries of the diabetic clinic unit contributed more than 95% of direct hospital fixed cost. Indirect hospital cost was 1.9% of the total hospital cost and more than 74% of that was IVC. Expenditure for water and electricity contributed 94.4% of IVC. The estimated mean annual household cost of diabetic clinic patient was $153.1. Indirect costs ($111.6) comprised of about 72% of the total household cost. Cost due to lost income ($102.7) contributed to 92% of the indirect costs. About 67% of direct household cost incurred for pharmaceuticals and laboratory investigations. Total annual government and patient cost was $221 out of which 69.3% was from household cost.

Conclusions
Total annual cost for attendance to the clinic in General Hospital Kandy was around $23364. The household cost of diabetic clinic attendants at the General Hospital , Kandy was considerably high.