Cost of medical care among type 2 diabetic patients with a co-morbid condition—Hypertension in India

Abstract 

The aim was to estimate the cost of medical care among hospitalized diabetic patients and to assess the influence of an additional co-morbid condition—hypertension. A pre tested and validated questionnaire was interviewer administered among 443 (male:female, 235:208) hospitalized diabetic patients. The JNC VII criteria for hypertension was considered to divide the study population into two groups; group I – diabetic patients without hypertension (n=269) and group II – diabetic patients with hypertension (n=174). Details of cost of inpatient and out-patient care and expenditure on hospitalization for the previous 2 years were obtained.

The prevalence of hypertension among the study subjects was 39.3% (174 subjects). Presence of hypertension made a significant impact on the expenditure pattern. On an average a diabetic patient with hypertension spent 1.4 times more than a diabetic subject without hypertension. Median cost per hospitalization, length of stay during admission, and cost of 2 years for inpatient admission were all significantly higher for diabetic patients with a co-morbid condition.

There is a need to develop a protocol on cost effective strategy for diabetes care. Strict control of hypertension should be targeted to avoid excess treatment cost on diabetes care.

Abbreviations: CVD, cardiovascular disease, HbA1c, glycosylated hemoglobin, JNC VII,, Joint National Committee, INR, Indian rupees

Keywords: Type 2 diabetes, Expenditure, Co-morbid condition, Hospitalization