Cost associated with hospitalization of non-adherent type 2 diabetes patients in a tertiary healthcare facility in Ibadan, Nigeria

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Purpose: To estimate the cost of hospitalization associated with medication non-adherence among type 2 diabetes mellitus (T2DM) patients in a tertiary healthcare facility in Nigeria. Methods: Three hundred and fifty-four (354) medical records of T2DM patients admitted into the medical wards from 2013 to 2015 were used for the study. Medical records with history of medication non-adherence (MNA) prior to hospitalization as indicated by physicians were included in the study. Direct medical costs associated with the management of the patients during hospitalization were measured using out-of-pocket payer perspective. Pearson product moment correlation coefficient was used to determine the relationship between the variables, with p < 0.05 considered statistically significant. Results: Among the 354 admitted patients, 226 (63.8 %) had a record of MNA. The mean age was 57.5years ± 14.6. The majority of the patients (61.5 %) were either petty traders or artisans/selfemployed. Duration of hospitalization increased with increase in number of comorbid disease (Pearson product moment correlation r = 0.13 p = 0.05). Total cost incurred during hospitalization was US$146,669.3 (average, $ 650.1), of which more than one quarter was cost of medications. Cost of management and cost of laboratory investigations increased with increase in the number of co-morbid diseases (r = 0.24, p = 0.00; r = 0.2, p = 0.02, respectively). Cost of management also increased with increase in days of hospitalization (r = 0.2, p = 0.00). Conclusion: Cost of hospitalization related to non-adherence to medication is high among the studied population. There is need to work out strategies to enhance adherence among diabetes patients.

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