Economic Burden of Type 2 Diabetes Mellitus Among Patients Attending Ho Teaching Hospital in the Ho Municipality, Ghana: A Cross‐Sectional Study

Background and Aims: Type 2 diabetes mellitus (T2DM) imposes a growing economic burden in Ghana, yet evidence on its financial impact is limited. This study assessed the economic burden of T2DM among patients receiving outpatient care at Ho Teaching Hospital. Methods: A cross-sectional cost-of-illness study was conducted between July and December 2024 among 118 T2DM patients. Data were collected using a structured questionnaire developed from a literature review and expert input and administered by trained student nurses. Monthly costs were estimated, and catastrophic health expenditure (CHE) was assessed using the budget share method at 10%, 25%, and 40% income thresholds, applying the 2024 national monthly minimum wage as a proxy. Logistic regression was used to identify predictors of CHE. Results: Most respondents (88.98%) were enrolled in the National Health Insurance Scheme (NHIS). The mean monthly cost of care was USD21.25, with direct medical costs (USD18.71) accounting for 88% of total expenditure, largely driven by medications (67.17%). Indirect costs due to productivity losses were minimal (USD0.40), although patients spent considerable time traveling (3.2 h) and at the facility (2.4 h) per visit. CHE prevalence was high: 100% at the 10% threshold, 95.76% at 25%, and 88.14% at 40% based on total costs. Older age (40-59 years), unemployment, and lack of tertiary education significantly increased CHE risk, while NHIS enrollment reduced risk at higher thresholds. Conclusion: Despite high NHIS coverage, T2DM care at Ho Teaching Hospital places a substantial financial burden on patients, with widespread catastrophic expenditure. Expanding NHIS benefits for tertiary diabetes services and reducing time and transport costs are essential to lessen the economic impact of T2DM in Ghana.