Health expenditure among the outpatient of type-2 diabetes in selected hospital of Kathmandu district: A cross-sectional study

Introduction Pocket (OOP) expenditure is the dominant financing mechanism in low and middle-income countries. In these countries, the prevalence of diabetes has been rising more rapidly, leading to various microvascular complications, thus increasing the risk of dying prematurely. Methods A cross-sectional - comparative and hospital-based study was carried out in which OOP expenditure of diabetic patients treated in public and private hospitals was compared. A total of 154 diabetic patients i.e.77 in each type of hospital were selected purposively in consultation with attending physicians and staff. Face to face interview was done on a diabetic patient with a minimum of one year of illness using a structured questionnaire. Lorentz curve and concentration curve were prepared using the income and expenditure of the patients. Result Among 154 patients, 97.4% of patients had paid out of pocket for the treatment of diabetes. The mean direct cost per month was NRs. 7312.17 in public and NRs. 10125.31 in a private hospital. The direct medical cost had a higher share in total direct cost i.e. 60.5% in public and 69.3 % in a private hospital. Medicine cost had a higher percentage share (50.9%) in public hospital and laboratory cost had a higher percentage share (68%) in a private hospital. Conclusion The direct medical cost was higher in a private hospital as compared to a public hospital. All the income groups have to pay a similar amount of money for the treatment i.e. economic burden for the treatment of disease was found higher for the poor people as there was no financial protection mechanism.