Assessment of Direct Cost of Care and Glycaemic Control among Diabetes Type 2 Patients in Two Mission Hospital Clinics in Kenya

Abstract

Non communicable diseases are fast becoming the leading cause of mortality and morbidity worldwide. It is estimated that 463 million people were living with diabetes in 2019. This number is estimated to increase by two folds by 2045. Diabetes mellitus, being a chronic disease, needs frequent hospital visits and follow up by clinicians. These contacts mean costs to the patient. The increase in cost limits the hospital visits, medications purchase and laboratory investigations which leads to poor management and prognosis. This study objective was to assess the direct cost of care and glycaemic control of diabetes mellitus type 2 patients attending diabetes clinics in two mission hospitals in Kenya. We used a cross-sectional study design was employed for this study. A Kirkwood formula was used to determine the sample size for this study at 384 participants. Random sampling technique was used to obtain the study subjects. A structured cost of care questionnaire having questions on direct medical and non-medical costs was used to collect data. Obtained data was analyzed using Microsoft excel and SPSS. Descriptive statistics entailed Frequency counts, mean median and percentages interquartile range while inferential statistics employed were- correlational and regression analysis. Most participants were aged over 60 with 21.6% being over 80 years. Mean total direct costs per visit was Kshs. 9,496.90 ± Kshs. 4,631.53 with drugs accounting for the larger proportion. Mean HbA1c and RBS values were established at 9.231% ± 2.4920% and 10.075 mmol/l ± 4.6503 mmol/l respectively. The direct cost of care of T2DM is still relatively high with a wide variation yet the levels of glycemic control are yet to be fully achieved in a larger proportion of diabetic type 2 patients