The Cost of Diabetes

By Dr. Oscar Jordan
Chairman, Barbados Diabetes Foundation

Chronic disease accounts for a disproportionate amount of government expenditure on health. Among the chronic diseases diabetes stands as the main bugbear.

Costs related to diabetes are classified as either direct or indirect. Direct costs are those directly related to the cost of managing the disease i.e. hospitalization costs, laboratory costs, fees for doctors, nurses, nutritionists, physiotherapists and other professional fees, cost of medication etc.

Indirect costs relate to time off work due to illness with obvious implications for sufferers, their families, their work places, insurance companies etc. Then there are the hidden costs which are impossible to quantify. These include the psychological burden to patients and their families as patients transition from providers to dependants because of some incapacitating diabetic complication.

In Barbados much of the direct cost, at least for patients in hospital, are borne by the Government. Only one definitive study has been done, to the best of my knowledge, to measure the impact of hospital costs for patients who are treated as in­-patients or out-patients at Queen Elizabeth Hospital or at the various polyclinics.

That study, carried out by Belle and his colleagues, suggests that as much as 15% of the total hospital budget was spent on diabetes-related conditions, in the year of the study, or approximately 18 million dollars. This figure does not include the costs of care conducted at private physicians’ offices or the associated or indirect costs for those patients.

Healthy Feedback

When Dawn Williams, communications officer with the Bloomberg Global Initiative of the Jamaica Heart Foundation, stepped out of today's general session, her enthusiasm was very apparent.

It was more than after glow of national pride from the success of the Jamaican team at the 2008 Summer Olympics; she was beaming at the prospects of leveraging the knowledge she had gained during these pass couple of days back home in Jamaica.

A major achievement I am excited about is the target to have a regional coalition of civil society among their NGOs (Non-Governmental Organizations) to really make a different through education and mobilization of citizens in their communities toward the reduction of CNCDs (Chronic Non-Communicable Diseases) and also lobbying governments, including my own, to either ratify the FCTC (Framework Convention on Tobacco Control) so that more Caribbean citizens can know how dangerous tobacco is. It's not just the lung cancer but it contributes significantly to whether people smoke or not."

Dawn was also very conscious of the need for this information to filter down from the white paper stage to the bite size chunks that the youth especially could digest. In Jamaica, they have a swift advantage in Usain Bolt, to show the youth that being healthy and successful takes time and effort.

"We use Bolt and others in Jamaica to show that it takes thorough years of preparation." Also by using edutainment and images of both sick and healthy people she hopes to convince the youth that their responsibility to themselves and future generations begins with how they value their health today.

"Some people believe that if they start smoking today it's no big deal that 'everybody has to die anyway' but the effects don't come until some 20 years later, often when you are starting a young family."

Article & Photos by Christal P. McIntosh, Healthy Caribbean 2008 Media Correspondent for PRMR Inc.

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