Syed Muhammad Ibrahim Hashmi, Shiraz Shaikh, Sana Tanzil, Lubna Baig, Nimra Shahid, Amna Abdullah.
Out of pocket payment for diabetes mellitus in a public hospital of Karachi..
J Pak Med Assoc Jan ;69(12):1864-75.

To estimate the out-of-pocket payment on routine management of type 2 diabetes in patients attending a public-sector facility. The cross-sectional study was conducted from December 2016 to May 2017 at Jinnah Postgraduate Medical Centre, Karachi, and comprised of persons with type 2 diabetes. A pretested questionnaire was administered to collect data from the patients. Comparisons of average out-of-pocket expenditure were done across different groups on the basis of gender, education, monthly income and duration of disease. SPSS 20 was used for data analysis. Of the 336 subjects, 178(53%) were males and 158(47%) were females. Overall mean age was 52.20+/-12.64 years, and 170(50.6%) were illiterate. The monthly mean cost on diabetes care was PKR 2217.70. People with academic level matriculation or higher spent more on the disease (p<0.001). Expenditure increased with the increase in number of years of disease (p<0.001). Participants with income of less than PKR 15000 spent higher percentage of their income compared to the participants earning more (p<0.001). High out-of-pocket expenditure was incurred by people with diabetes. The coverage of social security nets and individual insurance should be broadened to help improve diabetes management.

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