Endocrine Abstracts

Objective: The study set out to determine the out-of-pocket and indirect costs of treating diabetes mellitus in Nigeria.

Method: The study was conducted at two tertiary health facilities that are 25 km apart and operate under the same management, the Wesley Guild Hospital (WGH) and the Ife Hospital Unit (IHU) both in southwestern Nigeria. An interview-structured questionnaire and case note records were used to determine demographic variables, how much patients had expended on diabetes care, sources of funds for care, ability to cope with paying, number of clinic attendance and number of days spent on admission all in the preceding 12 months.

Results: There were 94 patients in all (M: F=1:1), the average age was 62 years, 29 were retirees and 83% of the patients were in the low socioeconomic class. The average clinic attendance was 8/12 months while the average duration of hospital stay was 38 days. The total cost of insulin, oral hypoglycaemics, other drugs and laboratory test was $51,986.00. Only six patients had their own glucometer. With respect to the ability to cope with paying for care, 56% of the patients reported that they cope with difficulty or great difficulty while a third had to depend on relations for diabetes care payment.

Conclusion: Our study just as in previous studies recorded a higher prevalence of diabetes in the elderly population. Majority of our patients are from the lower socio economic strata with poor education further compromising their ability to make wealth and fund their own care. This results inevitably to poor outcomes hence creating a vicious circle for perpetuating poverty.

The out-of-pocket and indirect cost of diabetes care appeared intolerably high to these mostly indigent patients. An effective health insurance scheme might ameliorate this presently unacceptable situation.