Wachara Riewpaiboon

Cost of diabetes and its complications in Thailand: a complete picture of economic burden

Diabetes is a common metabolic disorder with increasing burden in Thailand. The chronic nature along with associated complications makes the disease very costly. In Thailand, there exist some studies on cost of diabetes; however, those studies estimated the cost either from provider or from patient perspective. In order to capture the complete picture of economic burden caused by diabetes, using prevalence-based approach; the present study estimated the cost of illness of diabetes from societal perspective, the broadest viewpoint covering all costs irrespective of who incur them. Data were collected from 475 randomly selected diabetic patients who received treatment from Waritchaphum hospital in Sakhon Nakhon province of Thailand during 2007-2008 with a response rate of 98%. A micro-costing approach was used to calculate the cost. The direct medical cost was calculated by multiplying the quantity of medical services consumed by their unit costs while indirect cost was calculated by using human capital approach. The total cost of illness of diabetes for 475 study participants was estimated as USD 418,696 for the financial year 2008 (1 USD = 32 THB). Of this, 23% was direct medical cost, 40% was direct non-medical cost and 37% was indirect cost. The average cost of illness per diabetic patient was USD 881.47 in 2008 which was 21% of per capita gross domestic product of Thailand. Existence of complications increased the cost substantially. Cost of informal care contributed 28% of total cost of illness of diabetes. Therefore, the disease not only affected the individual but also the family members, friends and neighbours. The economic and social burden of the disease therefore emphasises the need for initiatives to prevent the disease prevalence and counselling to the diabetic patients to prevent the progression of the disease and its devastating complications.

Economic valuation of informal care in Asia: A case study of care for disabled stroke survivors in Thailand

This study values informal care for disabled stroke survivors in Thailand. It applies the conventional recommended opportunity cost method to value informal care in monetary terms. Data were collected by means of face-to-face interviews conducted during 2006. The sample consisted of 101 disabled persons who had suffered a stroke at least six months prior to the interview, and who had a functional status score of less than 95 as measured by the Barthel Index. Average monthly time spent on informal care was 94.6 hours, and the major source of opportunity cost was forgone unpaid work (43.5%). The average monthly monetary value of informal care was 4642.6 baht, based on 2006 prices. This study shows that providing informal care involves a substantial opportunity cost, implying a hidden value to Thai society.

Cost of informal care for diabetic patients in Thailand

AIMS The study estimated the cost of informal care for 475 randomly selected diabetic patients as identified by International Classification of Diseases, tenth revision (ICD-10 codes=E10-E14) and who received treatment at Waritchaphum hospital in Sakhon Nakhon province of Thailand during the financial year 2008. METHODS Informal care was valued by using revealed preference method. Information of informal caregiving was collected through direct personal interview method either from the patients or from the caregivers. The data on time spent for informal care were collected by using recall method. RESULTS The study covered a total of 190 informal caregivers. Average time spent on informal care was 112.38h per month. The estimated cost of informal care was USD 110,713.08 using opportunity cost approach and USD 93,896.52 using proxy good method in 2008 (1 USD=32 Thai Baht). CONCLUSIONS The study concluded that the hidden cost associated with informal caregiving is a burden for the Thai society. Hence, the economic cost associated with informal caregiving should be considered for future analyses of both the public health consequences of diabetes and interventions aimed at decreasing diabetic complications.

Disability and cost for diabetic patients at a public district hospital in Thailand

Objective  The study determined the rate of disability among diabetic patients at a public district hospital in Thailand and compared the costs of illness among different levels of severity of disability. This was the first such study carried out in Thailand.