Table 4.
Overall mean and median annual costs of diabetes care at five public facilities in Kenya (2017 US$)
| Care‐seeking Episode | Cost Category | n | Mean KES (95% CI) | Median KES (IQR) | Mean US$ (95% CI) | Median US$ (IQR) | As a % of Total Direct Costs |
|---|---|---|---|---|---|---|---|
| Sick visit | Direct health care costs | ||||||
| User charges | 59 | 7435.8 (2611.2‐12 260.4) | 4549.2 (1173.0‐6497.4) | 72.9 (25.6‐120.2) | 44.6 (11.5‐63.7) | 23.9 | |
| Medicines | 59 | 15 340.8 (6120‐24 561.6) | 5202.0 (1815.6‐12 872.4) | 150.4 (60.0‐240.8) | 51.0 (17.8‐126.2) | 49.3 | |
| Direct non–health care costs | |||||||
| Transport | 59 | 8037.6 (4845‐11 220) | 5202 (1815.6‐9098.4) | 78.8 (47.5‐110.0) | 51.0 (17.8‐89.2) | 25.8 | |
| Food | 59 | 326.4 (10.2‐632.4) | 0 | 3.2 (0.1‐6.2) | 0 | 1.0 | |
| Subtotal (direct costs) | 59 | 31 130.4 (18 961.8‐43 299.0) | 17 156.4 (8578.2‐32 762.4) | 305.2 (185.9‐424.5) | 168.2 (84.1‐321.2) | ||
| Indirect costs | 59 | 7466.4 (6262.8‐8659.8) | 6344.4 (3906.6‐8884.2) | 73.2 (61.4‐84.9) | 62.2 (38.3‐87.1) | ||
| Direct + Indirect costs | 59 | 38 596.8 (25 928.4‐51 265.2) | 24 388.2 (12 923.4‐41 524.2) | 378.4 (254.2‐502.6) | 239.1 (126.7‐407.1) | ||
| In‐patient admission | Direct health care costs | ||||||
| User charges | 16 | 16 717.8 (3264.0‐30 161.4) | 7170.6 (2203.2‐15 330.6) | 163.9 (32.0‐295.7) | 70.3 (21.6‐150.3) | 64.5 | |
| Medicines | 11 | 4008.6 (1366.8‐6660.6) | 3468 (683.4‐8496.6) | 39.3 (13.4‐65.3) | 34.0 (6.7‐83.3) | 10.6 | |
| Direct non–health care costs | |||||||
| Transport | 36 | 1917.6 (703.8‐3131.4) | 938.4 (418.2‐1734.0) | 18.8 (6.9‐30.7) | 9.2 (4.1‐17.0) | 16.6 | |
| Food | 17 | 2019.6 (204.0‐3825.0) | 795.6 (499.8‐1999.2) | 19.8 (2.0‐37.5) | 7.8 (4.9‐19.6) | 8.3 | |
| Subtotal (direct costs) | 36 | 11 526.0 (3825‐19 216.8) | 2478.6 (765.0‐14 932.8) | 113.0 (37.5‐188.4) | 24.3 (7.5‐146.4) | ||
| Indirect costs | 37 | 4804.2 (3376.2‐6242.4) | 3417.0 (1662.6‐6058.8) | 47.1 (33.1‐61.2) | 33.5 (16.3‐59.4) | ||
| Direct + Indirect costs | 37 | 16 014.0 (7548.0‐24 490.2) | 6507.6 (3498.6‐20 094.0) | 157.0 (74.0‐240.1) | 63.8 (34.3‐197.0) | ||
| Medicine collection | Direct health care costs | ||||||
| Medicines | 135 | 13 300.8 (9608.4‐16 983.0) | 5997.6 (3243.6‐13 198.8) | 130.4 (94.2‐166.5) | 58.8 (31.8‐129.4) | 87.3 | |
| Direct non–health care costs | |||||||
| Transport | 22 | 9690.0 (5385.6‐13 984.2) | 7201.2 (2397.0‐14 402.4) | 95.0 (52.8‐137.1) | 70.6 (23.5‐141.2) | 10.4 | |
| Food | 8 | 5936.4 (4304.4‐7568.4) | 7201.2 (4845.0‐7201.2) | 58.2 (42.2‐74.2) | 70.6 (47.5‐70.6) | 2.3 | |
| Subtotal (direct costs) | 136 | 15 116.4 (11 189.4‐19 043.4) | 8404.8 (3600.6‐15 595.8) | 148.2 (109.7‐186.7) | 82.4 (35.3‐152.9) | ||
| Indirect costs | 163 | 8017.2 (6446.4‐9598.2) | 5273.4 (3419.2‐9373.8) | 78.6 (63.2‐94.1) | 51.7 (33.5‐91.9) | ||
| Direct + Indirect costs | 163 | 20 634.6 (16 503.6‐24 765.6) | 12 739.8 (5803.8‐23 133.6) | 202.3 (161.8‐242.8) | 124.9 (56.9‐226.8) | ||
| Diagnostic visit | Direct health care costs | ||||||
| Test cost | 118 | 5222.4 (2029.8‐8404.8) | 1795.2 (1795.2‐3600.6) | 51.2 (19.9‐82.4) | 17.6 (17.6‐35.3) | 80.8 | |
| Direct non–health care costs | |||||||
| Transport | 21 | 5844.6 (4192.2‐7486.8) | 4804.2 (2397.0‐9598.2) | 57.3 (41.1‐73.4) | 47.1 (23.5‐94.1) | 16.1 | |
| Food | 7 | 3396.6 (1601.4‐5181.6) | 3600.6 (2397.0‐3600.6) | 33.3 (15.7‐50.8) | 35.3 (23.5‐35.3) | 3.1 | |
| Subtotal (direct costs) | 122 | 6252.6 (3111.0‐9384.0) | 1795.2 (1795.2‐3600.6) | 61.3 (30.5‐92.0) | 17.6 (17.6‐35.3) | ||
| Indirect costs | 161 | 4885.8 (4222.8‐5548.8) | 3886.2 (2641.8‐5865.0) | 47.9 (41.4‐54.4) | 38.1 (25.9‐57.5) | ||
| Direct + Indirect costs | 161 | 9618.6 (7068.6‐12 168.6) | 5661.0 (3825.0‐9455.4) | 94.3 (69.3‐119.3) | 55.5 (37.5‐92.7) | ||
| Scheduled clinics | Direct health care costs | ||||||
| User charges | 128 | 4610.4 (2723.4‐6507.6) | 2998.8 (2397.0‐4141.2) | 45.2 (26.7‐63.8) | 29.4 (23.5‐40.6) | 24.1 | |
| Medicines | 122 | 10 159.2 (7170.6‐13 147.8) | 5967.0 (2397.0‐11 995.2) | 99.6 (70.3‐128.9) | 58.5 (23.5‐117.6) | 50.5 | |
| Direct non–health care costs | |||||||
| Transport | 144 | 3957.6 (3325.2‐4579.8) | 2397.0 (1203.6‐4804.2) | 38.8 (32.6‐44.9) | 23.5 (11.8‐47.1) | 23.2 | |
| Food | 11 | 4834.8 (397.8‐9271.8) | 2397.0 (1795.2‐4804.2) | 47.4 (3.9‐90.9) | 23.5 (17.6‐47.1) | 2.2 | |
| Subtotal (direct costs) | 163 | 15 045.0 (12 056.4‐18 023.4) | 9843.0 (4804.2‐17 401.2) | 147.5 (118.2‐176.7) | 96.5 (47.1‐170.6) | ||
| Indirect costs | 163 | 4396.2 (3957.6‐4824.6) | 3519.0 (2611.2‐5865.0) | 43.1 (38.8‐47.3) | 34.5 (25.6‐57.5) | ||
| Direct + Indirect costs | 163 | 19 441.2 (16 207.8‐22 664.4) | 14 259.6 (7476.6‐23 878.2) | 190.6 (158.9‐222.2) | 139.8 (73.3‐234.1) | ||
| Overall costs | Direct health care costs | ||||||
| User charges | 135 | 11 413.8 (6987.0‐15 840.6) | 6293.4 (5467.2‐9251.4) | 111.9 (68.5‐155.3) | 61.7 (53.6‐90.7) | 17.5 | |
| Medicines | 138 | 33 374.4 (25 092.0‐41 656.8) | 19 818.6 (8404.8‐38 403.0) | 327.2 (246.0‐408.4) | 194.3 (82.4‐376.5) | 52.4 | |
| Direct non–health care costs | |||||||
| Transport | 147 | 12 168.6 (9894.0‐14 433.0) | 7599.0 (3702.6‐14 800.2) | 119.3 (97.0‐141.5) | 74.5 (36.3‐145.1) | 22.6 | |
| Food | 31 | 6232.2 (2743.8‐9720.6) | 2397.0 (7956.0‐6497.4) | 61.1 (26.9‐95.3) | 23.5 (78.0‐63.7) | 7.5 | |
| Subtotal (direct costs) | 163 | 53 907.0 (43 625.4‐64 188.6) | 35 802.0 (16 462.8‐59 884.2) | 528.5 (427.7‐629.3) | 351.0 (161.4‐587.1) | ||
| Indirect costs | 163 | 23 174.4 (20 910.0‐25 438.8) | 19 216.8 (13 963.8‐28 417.2) | 227.2 (205.0‐249.4) | 188.4 (136.9‐278.6) | ||
| Direct + Indirect costs | 163 | 77 081.4 (65 820.6‐88 342.2) | 58 415.4 (33 966.0‐90 922.8) | 755.7 (645.3‐866.1) | 572.7 (333.0‐891.4) |