MUST DIABETES BE A FATAL DISEASE IN AFRICA - STUDY OF COSTS OF TREATMENT

被引:45
作者
CHALE, SS [1 ]
SWAI, ABM [1 ]
MUJINJA, PGM [1 ]
MCLARTY, DG [1 ]
机构
[1] MUHIMBILI MED CTR,DEPT BEHAV SCI,DAR ES SALAAM,TANZANIA
关键词
D O I
10.1136/bmj.304.6836.1215
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective - To estimate the costs of diagnosis and treatment of diabetes in Tanzania. Design - Costs estimated from the reported and recorded experience of patients with newly presenting diabetes in 1989-90 and of diabetic patients first seen in 1981-2. Setting - Muhimbili Medical Centre, Dar es Salaam. Subjects-464 patients (315 men and 149 women). 262 patients diagnosed during 1 September 1989-31 August 1990 (group 1) and 202 during 1 June 1981-31 August 1982 (group 2). Results-The average annual direct cost of diabetes care in 1989-90 was $287 for a patient requiring insulin and $103 for a patient not requiring insulin. Purchase of insulin accounted for 68.2% ($156) of the average annual outpatient costs for patients requiring insulin. For patients not requiring insulin the cost of oral hypoglycaemic drugs and treatment of chronic complications and infections accounted for 42.5% ($29.3) and 48.8% ($33.7) of costs respectively. Cost of outpatient care of diabetic patients for the whole of Tanzania was estimated at $2.7 m, $875 128 (32.2%) of which was for insulin. Doctors' and nurses' costs accounted for 0.2% of total costs of outpatient care. The annual direct inpatient care costs were estimated at $1.25m. Around 0.2% of the Tanzanian population aged 15 years and over used the equivalent of 8% of the total government health expenditure, which was $47 408 382. Conclusion - Diabetes places a severe strain on the limited resources of developing countries. If African patients with diabetes have to pay for their treatment most will be unable to do so and will die.
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页码:1215 / 1218
页数:4
相关论文
共 16 条
[1]   RATIONING HEALTH-CARE - THE CHOICE BEFORE US [J].
AARON, H ;
SCHWARTZ, WB .
SCIENCE, 1990, 247 (4941) :418-422
[2]  
CORRIGAN CB, 1987, E AFR MED J, V64, P772
[3]  
Enthoven A., 1984, HLTH DIS, P335
[4]  
FOX NA, 1988, DIRECT INDIRECT COST
[5]  
JOHNSON B, 1983, ACTA MED SCAND S, V671, P19
[6]  
LAING W, 1989, DIABETES MODEL HLTH, P32
[7]  
MCLARTY DG, 1989, LANCET, V1, P871
[8]   DIABETES IN TROPICAL AFRICA - A PROSPECTIVE-STUDY, 1981-7 .2. COURSE AND PROGNOSIS [J].
MCLARTY, DG ;
KINABO, L ;
SWAI, ABM .
BRITISH MEDICAL JOURNAL, 1990, 300 (6732) :1107-1110
[9]  
ROLFE M, 1989, J ROY COLL PHYS LOND, V23, P255
[10]   USE OF HEALTH-SERVICES BY DIABETIC PERSONS .2. HOSPITAL ADMISSIONS [J].
SCOTT, RS ;
BROWN, LJ ;
CLIFFORD, P .
DIABETES CARE, 1985, 8 (01) :43-47