Household Economic Burden and Healthcare Utilization Among Adults With Type 2 Diabetes Mellitus: A Hospital-Based...

Background Type 2 diabetes mellitus (T2DM) is a major public health challenge that places a substantial economic burden on households because of lifelong treatment and monitoring requirements. Evidence on the household financial burden of diabetes in rural India remains limited. This study estimated the household cost of illness associated with T2DM and assessed healthcare utilization among adults attending a rural tertiary care teaching hospital in North India. Methods A hospital-based cross-sectional study was conducted among 400 adults with T2DM who had been receiving treatment for at least six months. Participants were enrolled consecutively. Data were collected through face-to-face interviews using a pretested semi-structured questionnaire to capture sociodemographic characteristics, clinical profile, healthcare utilization, and diabetes-related expenditure. Household costs were estimated from the patient perspective and categorized into direct medical, direct nonmedical, and indirect costs. Results The mean age of participants was 55.2 ± 8.5 years, and 58.3% had diabetes for 5-10 years. The mean annual household expenditure attributable to diabetes was ₹15,204 (₹1,267/month), with direct medical costs accounting for 76.7% of total expenditure. Most households (73.5%) incurred annual diabetes-related expenses between ₹10,001 and ₹20,000. Most participants (85.5%) used outpatient care, and 96.5% preferred allopathic treatment. Overall, 14.5% of households spent more than 30% of their monthly household income on diabetes care, indicating substantial financial vulnerability. Conclusions T2DM imposes a considerable economic burden on rural households, with direct medical expenditure being the principal cost driver. Strengthening primary healthcare, improving access to affordable medicines, and expanding financial risk protection mechanisms are essential to reducing out-of-pocket expenditures.