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Health Expenditure on Diabetes, 2013

on Wed, 11/27/2013 - 06:46
In a previous article published in Health Intelligence, the levels and distribution of the prevalence of diabetes in adult population worlwide was assessed. In this new article we want to highlight the economic burden of diabetes. 
Diabetes, as a chronic disease, imposes a large economic burden on individuals, families, national health systems and national economies. Disability of people with diabetes in productive ages impact negatively on national economies.  According to the Sixth Edition of the IDF Diabetes Atlas, health expending on diabetes accounted for 10.8% of total health expenditure worldwide in 2013 and about 90% of the countries included in Diabetes Atlas report dedicated between 5% and 18% of their total health expenditure to diabetes.


Health expenditure on diabetes includes medical spending on diabetes by health system and by people with diabetes and their families. Diabetes-related expenditure per person with diabetes, expressed in US dollars is used as a metric. 
The data source used in this article is Sixth Edition of the International Diabetes Federation Diabetes Atlas. Data visualization was designed to support key findings and results in this article. It includes three visuals, a scatter plot having age-standardized diabetes prevalence expressed in percentage on X-axis and diabetes-related expenditure per person with diabetes, expressed in US dollars in Y-axis. Every dot on the chart represents a country and the size is the standardized mortality rate due to diabetes per 100,000 populations.  Median of diabetes prevalence and expenditure on diabetes were superimposed to the scatter plot. Countries were color code according to the quadrant on the scatter plot they are located, and the distance to the median, getting darkest when they are far from the median center. The blog post Dual Axis Colouring of a Scatter Plot by Peter Gilks describes the technique and how to create this type of scatter plot in Tableau Software .   

Key findings

Globally it is estimated that 382 million people suffer diabetes in 2013, for a prevalence of 8.3% and a global health spending of $548 million dollars to treat them and manage their complications. An estimated median of $455 USD per person with diabetes was spent globally. 
There is a large disparity of expenditure on diabetes between countries. Most of the countries (140) spent less than $1,000 USD per person with diabetes and few of them -just six, on the other side of the tail- spent more than $7,000 USD per people with diabetes. 
High income countries spent a very large amount of money on diabetes per person, having in the top four countries:  Norway spending an average of $10,369 USD, Luxembourg spending $10,206 USD, Switzerland spending $9,873 USD and United States of America spending $9,800 USD. The expenditure of these four countries is more than 340 times higher than the amount of money expended by Somalia, the country with lesser value, $21 USD per person with diabetes. It is also important to highlights that people living in low and middle-income countries are paying a large share of health expenditure due to the lack access to health insurance and the availability of public healthcare services.  
Data visualization shows that countries with high prevalence of diabetes are spending an insufficient amount of money on diabetes, which is impacting in an excess of mortality, such is the case of Marshall Islands, Federated States of Micronesia, Kiribati, Vanuatu and Nauru, countries with a high mortality rate due to diabetes. 

Conclusions and recommendations

Those countries with high diabetes prevalence and mortality should take actions to improve access to treatment and health services to those people with diabetes.
Diabetes treatment is expensive, so people, families, and governments should find contextualized solutions to make sure every diabetic person receives the required treatment.
People should learn about risks of diabetes and take actions to prevent the disease. Life-style, lack of exercise, unhealthy diet, obesity and overweight are the most important risk factor to develop diabetes.  In case a person develops diabetes, he or she should seek medical attention and treatment as soon as possible.   



P.S. The visualization of this article was selected by Tableau Public as Visualization of the Day on November 28th, 2013.

Tableau Public Visualization of the Day, November 28th, 2013


Peter Gilks's picture

There seems to be little relationship between the two. I'm guessing that diet plays a much bigger role than treatment ever can. Too much Spam in the South Pacific!

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