Gender difference in quarterly out of pocket expenditure on Diabetes care in Thoothukudi – a cross-sectional study.

Abstract

Background: Diabetes Mellitus is a long term disease which require higher medical expenditure. If inadequately treated or undiagnosed, it leads to multiple chronic complications, which again increase the expenditure multi-fold. Gender has got implications in diabetes care due to sex differences as well as that of social inequities entrenched within gender. This study is done to compare quarterly Out of Pocket expenditure (OOPE) on diabetes care with gender as a covariate. Methods : Quarterly OOPE is defined as any expenditure incurred by households as a payment to health practitioners and suppliers of pharmaceuticals, therapeutic appliances and other goods and services during the last three months due to diabetes. A cross sectional study was done in Thoothukudi Corporation among 180 diabetic patients using a semi structured questionnaire. Results: Among the study participants, 49.2%were males and 50.8% were females. The median quarterly OOPE for males was  Rs.2387 with an interquartile range of Rs.2742 and that of  females was Rs.1249.42 with an interquartile range of Rs.2836 which was statistically significant(p value -.0.01). The proportion of family monthly income spent on diabetes care was also significantly lower for women(2.6%) compared to men (4.48%).  Conclusion: The quarterly OOP expenditure was significantly lower among women compared to men. In a country like India, where larger share of health expenditure is contributed through OOPE, this finding is revealing that gender equity in diabetes care is nowhere near its reach.