The personal costs of diabetes : a significant barrier to care in South Auckland

AIM: 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.