Burden of disease and out-of-pocket expenditures associated to type 2 diabetes and its complications in Argentina

JORGE ELGART; LORENA GONZALEZ; JOAQUIN CAPORALE; JORGE DE LA FUENTE; CECILIA CAMILLUCCI; JUAN J GAGLIARDINO

Congreso; 48th EASD Annual Meeting of the European Association for the Study of Diabetes; 2012

AIMS: To assess a) the economic impact of diabetes on quality of life, disabilities and health utilities, on the income, employment, education and property of patients and their families, b) the efficiency of medical care received by people with type 2 diabetes (T2DM) with and without complications in Argentina and c) compare these costs with those recorded in people without diabetes. METHODOLOGY: Case-control study comparing cases with T2DM with or without chronic micro-and macrovascular complications and controls without diabetes (paired by age and gender) and social contexts. Data was obtained by telephone interviews (March to April 2011) using identical questionnaire except for a few questiones related to diabetes treatment. Interview data were supplemented with data obtained from clinical records from each interviewed to fully describe the subjects resources utilization and costs of care. Data was statistically analyzed using the Statistical Package for Social Sciences (SPSS) version 15. Differences in means and proportions were verified using Student?s t test, ANOVA and Chi2. The study had ethical clearance and all subjects provided oral informed consent. RESULTS: We interviewed 1908 patients (954 non diabetic controls, 477 people with T2DM without complications, and 477 people with T2DM and complications), mostly female (52.4%, 56.6% and 50.5%, respectively). The diabetes duration in the group with complications was significantly higher than in the group without complications (8.3 ± 8.6 vs. 11.1 ± 9.0). Persons with T2DM with complications have significantly lower salaries, lower percentage of people attained university degree, higher hospitalization rate and resources consumption; they also have lost more working days (14.3) than those either with T2DM without complications (8.6) or those without T2DM (8.8). CONCLUSSION: This is the first report showing objectively the wide heavy burden of diabetes and its complications for the patient, its family, the health systems and the overall society in a Latin American country. The data provide a serious warning to health care authorities to strenght the implementation of prevention strategies to reduce this burden.