The Direct Costs of type 2 Diabetes Mellitus Outpatient care in the Ghanaian Public Health System: A Case of the Cape Coast Teaching Hospital

Background Diabetes Mellitus (DM) is a growing epidermic with its parallel economic impact on the health system and society. The objective of this study was to estimate the direct medical and direct non-medical costs of type 2 diabetes outpatient care in a Ghanaian Public Health Care System. Methods The study was conducted at the Cape Coast Teaching Hospital outpatient diabetes clinic from January, 2016 through May, 2016. A total of 204 randomly selected patients with diabetes attending the diabetes clinic were interviewed and their medical records data reviewed. Direct medical costs included expenses with anti-diabetic medications, diabetes-related laboratory tests, blood glucose strips and consultations with healthcare professionals. Direct non-medical costs included expenses with transportation, artificial sweeteners and herbal medicines. Results The annual mean direct medical cost for outpatient care for a person with DM was 1, 491.45 Ghana cedis (US$ 390.43) on oral anti-diabetics paid by the National Health Insurance Scheme, out of which medications accounted for the largest proportion of the direct medical cost (42.7 %), followed by cost of glucose strips (16.6 %). Also, on the average a person with diabetes spend out of pocket of 188.29 GHS (US$ 49.29) per year in private pharmacies for diabetes medications. Also longer duration of the disease was associated with increased cost and the mean annual direct medical cost was higher in females than males (US$ 362.98 vs $332.58). Having hypertension and dyslipidaemia as co-morbities added an additional cost of US$ 123.02 and $90.16 respectively on medications for treatment annually. The mean direct non-medical cost was GHS 110.93 (US$ 29.04), out of which transportation accounted for the largest proportion (52.3 %). Conclusion This study showed that outpatient diabetes management leads to elevated cost to the Ghanaian Public Health care System. Costs increased along with duration of disease and presence of co-morbities. There is the need to focus on primary prevention of diabetes, its co-morbidities and complications.