Stream
Abstract - Living with Diabetes
Topic
Healthcare financing
Abstract title
Effect of cost on financial support of self-care practices of people with diabetes
Co-authors	
K. ahmed1, R. hakeem1, H. shaikh1, M. abdeali2, A. salaheen2.
1baqai institute of diabetology and endocrinology-baqai medical university, Diet and Education, karachi, Pakistan.
2baqai institute of diabetology and endocrinology - baqai medical university, diet and education, karachi, Pakistan.
Abstract body	
Background
The number of patients with type 2 diabetes is increasing rapidly in both developed and developing countries around the world. Patients with diabetes are more than twice as costly to manage as non-diabetic patients, due mainly to the high costs associated with management of diabetic complications. Demand of huge amount for the treatment of diabetes is extremely difficult for people belonging to a third world country, resulting in stressing the resources of an already burdened society.

Aim
To find out expenditure of persons with diabetes in treatment of diabetes and explore difference in diabetes care costs of self paying and financially supported subjects.

Method
Data was collected using a structured close ended questionnaire via convenient sampling. All the participants included in the research were attending Baqai Institute of Diabetology and Endocrinology, a tertiary care unit, situated in Karachi. Questions included in the questionnaire were in two parts. First part inquired about gender, age, earning criteria, person bearing the expense and level of education. The second part had questions regarding cost of medicines, doctor visit, consultation to the dietitian, blood tests and self-monitoring blood glucose (SMBG) test. The total expenses were calculated on per annum basis. Data was then entered and analysed using SPSS version 20.

Results
A total of 100 patients with diabetes participated in the study. 57% of the participants were male and 43% were female. 76% of the patients were self-paying, 24% were supported out of which 22% were zakat dependent, 2% were on company panel. The annual median cost of diabetes care in PKR for all expenses combined was 45089, SMBG: 3840, medicines: 28800, dietician: 250, laboratory tests: 1646 and visit to doctor: 2075. Highest proportion of cost was incurred on medicines 83.57% followed by the cost of SMBG tests 8.49%, visit to the doctor 4.16%, blood tests 3.12%, and visit to the dietitian 0.66%. As compared to supported subjects, for self-paying subjects estimated mean annual expenditure was significantly lower on SMBG (PKR 7308 & 4080 respectively P= 0.007), dietician (PKR  489 & 338 respectively P= 0.07), and   notably lower for laboratory tests (PKR   2410 & 1583 respectively P= 0.055).

Discussion
In this study medical care of financially supported subjects does not seem to be compromised due to fiscal constraints. Differences in mean expenditure indicate that the ones who are not eligible or willing to get financial support may be compromising on some aspects of their diabetes care. Universal free medical care for people with diabetes by the government can definitely improve their health and give economic dividends to the country.