title: Economic burden and catastrophic cost among people living with type2 diabetes mellitus attending a tertiary health institution in south-east zone, Nigeria.
abstract: BACKGROUND
  Diabetes mellitus (DM) is a life-long illness that affects the quality of life, requiring close monitoring and control. Type 2 DM is preventable and controllable but increasing cost of care could hinder access to quality care because of inability to pay leading to high morbidity, mortality and productivity losses. The people living with diabetes mellitus (PLWD) in Nigeria have high risk for high economic burden and catastrophic expenditure not only because they make frequent visits to the health facilities, report late with complications but also pay out of pocket at the point of accessing care. The aim of this study was to assess the magnitude of economic burden borne and catastrophic costs incurred by PLWD in Nigeria.
  
  
  METHODS
  Cross-sectional descriptive survey design was used to study a sample of 308 type2 PLWD managed at a tertiary health institution, South east Nigeria using semi-structured, prevalidated questionnaire. Data collection period was 2 months.
  
  
  RESULTS
  The major findings were economic burden of type 2 DM of N56,245 ($356). Catastrophic direct cost was 45 % at 30 % threshold (the determinant level for catastrophic spending set). All socio-economic status (SES) groups suffered catastrophic expenditure but the poorest quartile had the highest incidence.
  
  
  CONCLUSIONS
  Economic burden of DM was high for PLWD who also suffered high catastrophic costs due to the impact of out of pocket payment. PLWD need financial protection especially for the poorest since they buy from the same market and incur same costs. Policy decision making to assist the PLWD cope with cost of care is needful in Nigeria and nations with related problems.
authors.affiliation: Department of Health Administration and Management, University of Nigeria Nsukka, Enugu Campus, Enugu, Enugu State, Nigeria. ijeoma.okoronkwo@unn.edu.ng.
authors.forename: Ijeoma L
authors.initials: IL
authors.lastname: Okoronkwo
authors.affiliation: Federal Medical Centre Umuahia, Umuahia, Abia State, Nigeria. ekpemiroj@gmail.com.
authors.forename: Jessie N
authors.initials: JN
authors.lastname: Ekpemiro
authors.affiliation: Federal Medical Centre Umuahia, Umuahia, Abia State, Nigeria. ednauzoamaka@gmail.com.
authors.forename: Edna U
authors.initials: EU
authors.lastname: Okwor
authors.affiliation: Department of Nursing, University of Nigeria Nsukka, Enugu Campus, Enugu, Enugu State, Nigeria. favouredpat4@yahoo.com.
authors.forename: Pat U
authors.initials: PU
authors.lastname: Okpala
authors.affiliation: Department of Nursing, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Osun State, Nigeria. doctoradeyemo@yahoo.com.
authors.forename: Florence O
authors.initials: FO
authors.lastname: Adeyemo
mesh_terms: D000328:Adult; D000368:Aged; D017281:Cost of Illness; D003710:Demography; D003924:Diabetes Mellitus, Type 2 / Q000191:economics*; D005260:Female; D005102:Health Expenditures; D006801:Humans; D008297:Male; D008875:Middle Aged; D009549:Nigeria; D012959:Socioeconomic Factors; D063128:Tertiary Health Care