The economic burden of type 2 diabetes mellitus in rural southwest China

Background: This study was conducted in order to estimate the economic burden of diabetes in a given year in rural Yunnan province of China, including direct, indirect and intangible costs.

Methods: A cross-sectional survey was conducted in rural southwest China in early 2011 among 9396 consenting individuals aged ≥ 18 years. Information on participants' demographic characteristics, and economic consequences and related aspects of diabetes were obtained using a standard questionnaire. Fasting blood sugar level was also measured for each individual. Years of life lost (YLL) due to diabetes was estimated using medical death certificates. A prevalence-based cost-of-illness method was used to estimate the economic burden of diabetes.

Results: The overall prevalence and YLL of diabetes was 6.5% and 1168.1 years in the study population, respectively. Total cost of illness related to diabetes was estimated to be $46.8 million. Mean unit direct medical costs, direct non-medical costs, morbidity costs, mortality costs, intangible costs, and cost of illness were $863.2, $44.6, $59.7, $7797.7, $936.2, and $9686.6, respectively. Direct costs accounted for the largest proportion of the economic costs of diabetes. Age was positively associated with direct costs whereas negatively associated with indirect costs. Patients aged 45-59 years incurred the highest intangible costs. Both indirect and intangible costs increased with level of education.

Conclusions: Diabetes is a major public health problem in terms of morbidity and economic burden in rural southwest China. The region should increase investment in the further control of diabetes, and improvement of patient quality of life.