Assessment of out-of-pocket expenditure on noncommunicable diseases in urban slum of Mysuru City

Abstract

Background: Noncommunicable diseases (NCDs) are the leading cause of death and disability globally, and the burden is expected to grow rapidly in developing countries. In the absence of health insurance, public provisioning, and donor funds, the management and treatment of NCDs such as hypertension and diabetes might result in very large out-of-pocket expenditures (OOPEs) for households. Objectives: The objectives were as follows: to estimate OOPE and to study the association between sociodemographic characteristics and OOPE among patients suffering from NCDs. Materials and Methods: The sample size was estimated based on a mean OOPE of 63.5 Indian rupees (INR), with a standard deviation (SD) of 110 INR, a sample size of 464 was obtained, and individuals with NCDs were interviewed. Results: Of the total 464 participants, 325 (70%) were female and 139 (30%) were male, with a mean (SD) age of 55.78 ± 13.204. Three hundred and two (65.1%) participants were having hypertension and 232 (50%) were having diabetes. The mean total OOPE was 1173.0603 (INR), with a SD of 1424.54108 (INR), and the mean direct cost incurred was 1141.03. The mean (SD) direct cost spent for medication was 895.61 ± 1100.32, for the laboratory was 148.38 ± 440.7, and for consultation was 97.04 ± 113.86. Only 34 (7.7%) participants were having health insurance. There was an association between the OOPE and sociodemographic profiles such as occupation, educational status, and economic status where the P (<0.05) was noted as P = 0.004, P = 0.024, and P < 0.001, respectively. Conclusion: Knowledge and awareness about health insurance scheme and their benefits help in reducing the OOPE.