Cost burden to diabetic patients with foot complications--a study from southern India

To study the economic burden of management of diabetes in patients with foot complications, as a large number of them suffer from foot complications of varying severity. This study relates to direct cost to diabetic patients with foot complications.

An illustrative sample of 270 Type 2 diabetic subjects, 164 without foot complications (Control group, Group 1) and 106 with foot complications (Group 2) were studied. They were available for the study during a six month period from January to June 1998. Group 2 had two sub-groups, i.e., those who needed out-patient (OP) treatment only (n = 23) and those who needed treatment in the hospital (HP) (n = 83). The study subjects were interviewed personally by the educator to collect demographic data and treatment expenditure.

Total median expenditure incurred by the diabetic subjects without foot complications (Group 1) was Rs. 4373/- and by those with foot complications (Group 2) was Rs. 15,450/-. Patients who required hospitalised treatment incurred higher expenses than the OP patients, towards doctor's fees and hospitalisation (P < 0.0001). The percent of total income spent by the HP patients was higher than by the OP patients (P < 0.02).

Diabetic subjects with foot problems incur very heavy expenditure in the treatment process. Most of the direct costs of diabetes treatment results from its complications. The hospitalisation costs for the complications of diabetes are particularly heavy. This underscores the need to reduce complications and also their economic burden.