title: The personal costs of diabetes: a significant barrier to care in South Auckland.
abstract: OBJECTIVE
  To estimate the out-of-pocket expenses associated with diabetes care and their impact on self-care activities in inner urban South Auckland.
  
  
  METHODS
  Follow-up, cross-sectional household survey among 1629 residents with known diabetes. A brief questionnaire was completed during either two consecutive mail surveys or a subsequent household visit to diabetic patients identified in a previous household survey.
  
  
  RESULTS
  Responses were obtained from 802 (75%) of the 1075 subjects remaining resident in the area. Median annual costs of scripts, shoes, clinic and general practice visits ranged between $191-$329 depending on ethnic group. Costs were higher among males, those requiring insulin therapy and those aged under 60 years. A significant proportion of subjects reported that these costs prevented regular self-blood-glucose monitoring (18-49%), self-medication (11-47%) and regular insulin therapy among insulin-treated patients (8-52%).
  
  
  CONCLUSIONS
  The out-of-pocket expenses associated with diabetes remain a substantial portion of disposable income and a barrier to the prevention of diabetes-related complications. These data support the provision of preventive diabetes care at no cost to the patient at the point of care.
authors.affiliation: Department of Rural Health, University of Melbourne, Goulburn Valley Base Hospital, Victoria, Australia. d.simmons@medicine,unimelb.edu.au
authors.forename: D
authors.initials: D
authors.lastname: Simmons
authors.forename: A
authors.initials: A
authors.lastname: Peng
authors.forename: A
authors.initials: A
authors.lastname: Cecil
authors.forename: B
authors.initials: B
authors.lastname: Gatland
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003920:Diabetes Mellitus / Q000191:economics* / Q000628:therapy; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D017048:Health Care Costs; D019538:Health Care Surveys; D006801:Humans; D007182:Income; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010349:Patient Compliance; D012648:Self Care / Q000191:economics*