title: Treatment of Type 2 diabetes mellitus in Chongqing of China: unaffordable care for the poor.
abstract: This study aims to investigate the medical expenditure of people with Type 2 diabetes mellitus in Chongqing, China; to explore factors that contribute to the expenditure; and to examine the financial burden placed on households, particularly poor households.
  
  
  
  A cross sectional survey was conducted with a sample of people diagnosed with Type 2 diabetes mellitus in 2014. Of the 664 people eligible, 76% were interviewed. Descriptive statistics and log-linear regression were used to examine respondents' age, sex and level education, location of residence, income and type of health insurance associated with out-of-pocket expenditure on accessing diabetes mellitus care.
  
  
  
  In a year, average out-of-pocket expenditure on the purchase of drugs from pharmacies and having outpatient care were US $333 and US $310, respectively. The average out-of-pocket expenditure on accessing inpatient care was 3.7 times (US $1159) that of accessing outpatient care. After adjusting for age and sex, out-of-pocket expenditure on diabetes care was significantly higher for people covered by the Urban Employee Basic Medical Insurance programme and those enrolled in the identified priority diseases reimbursement programme, which provided higher reimbursement rates for outpatient and (or) inpatient care. Out-of-pocket expenditures on the purchase of drugs from pharmacies, having outpatient and inpatient care, respectively, were 9.8%, 16.2% and 62.6% of annual household income in low-income group.
  
  
  
  Even with health insurance coverage, poor people with Type 2 diabetes mellitus suffered from significant financial hardship. This has significant implications for models of care and healthcare financing in China with the growing burden of diabetes.
authors.affiliation: Global Health Research Center, Duke Kunshan University, Kunshan, China.|Duke Global Health Institute, Duke University, Durham, NC, USA.
authors.forename: Q
authors.initials: Q
authors.lastname: Long
authors.affiliation: School of Public Health and Management, Chongqing Medical University, Chongqing, China.
authors.forename: M
authors.initials: M
authors.lastname: He
authors.affiliation: School of Public Health and Management, Chongqing Medical University, Chongqing, China.
authors.forename: X
authors.initials: X
authors.lastname: Tang
authors.affiliation: School of Medicine and Health Sciences, Monash University Malaysia, Selangor Darul Ehsan, Malaysia.
authors.forename: P
authors.initials: P
authors.lastname: Allotey
authors.affiliation: Global Health Research Center, Duke Kunshan University, Kunshan, China.|Duke Global Health Institute, Duke University, Durham, NC, USA.
authors.forename: S
authors.initials: S
authors.lastname: Tang
mesh_terms: D000368:Aged; D002681:China; D003131:Combined Modality Therapy / Q000191:economics; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000191:economics / Q000628:therapy*; D005191:Family Characteristics; D005260:Female; D019538:Health Care Surveys; D005102:Health Expenditures; D019456:Health Transition; D054625:Healthcare Disparities; D017722:Hospital Charges; D006801:Humans; D007004:Hypoglycemic Agents / Q000191:economics / Q000627:therapeutic use; D007349:Insurance, Health, Reimbursement; D008297:Male; D008875:Middle Aged; D011203:Poverty; D011306:Prescription Fees
chemical_list: D007004:Hypoglycemic Agents