Out-of-Pocket Expenditure and Catastrophic Health Spending Among Patients With Type 2 Diabetes in Rural Tamil Nadu: A Cross-Sectional Study.

Background and objectives Diabetes mellitus is one of the most predominant noncommunicable diseases (NCDs) globally as well as in India. Apart from morbidity and mortality, it causes a significant burden on the healthcare resources of the nation as well as the households. High expenses toward healthcare can potentially impoverish a household. Hence, this study was conducted to assess the economic burden involved in the management of diabetes among the rural population. Materials and methods The study was conducted in the Rural Health and Training Centre of Sri Ramachandra Medical College. Data was collected using a semistructured questionnaire, regarding their sociodemographic details, duration of illness, comorbidities, glycemic levels, complications of diabetes, compliance to treatment, and all direct and indirect expenses for the management of diabetes mellitus in the last 3 months. Results The mean quarterly out-of-pocket expenditure (OOPE) was 1159 ± 1374₹, in which direct expenses were 727 ± 1124₹, and indirect expenses came to around 413 ± 712₹. Catastrophic health expenditure (CHE) was present in 6.6% (3.65-10.83) of them. The mean expenditure was significantly lower in people who availed government and other free or subsidized healthcare services, and higher in those who were on insulin therapy.  Conclusion Our existing health system and policies need to be further strengthened, and health coverage and schemes should be made accessible to a larger population to avoid adverse financial implications.