The Impact of the Past Three-year Economic Crisis on Type 2 Diabetes Mellitus Patients’ Self-care Practices and Healthcare Expenditure in Southern Sri Lanka: A Cross Sectional Study.

Abstract

Background: The impact on the Sri Lankan population from the economic crisis occurred over past three years warrants significant attention. The management strategies associated with chronic disease conditions, such as diabetes mellitus (DM), are subject to change based on individuals’ experiences during economic transformations. Objectives: To assess the impact of the past three-year economic crisis on self-care practices, care-seeking behaviour, and healthcare expenditure among Type 2 DM patients at primary care institutions in Southern Sri Lanka Methods: A descriptive cross-sectional study was conducted in five primary care institutions (Ahangama, Baddegama, Hikkaduwa, Rathgama and Unawatuna) in the Galle district of Southern Sri Lanka recruiting 425 participants using a convenient sampling technique. A self-developed, pre-tested, interviewer-administered questionnaire was used to collect data. Results: The majority of the study sample consisted of female individuals (79%) aged between 51-65 years (46%), who had been diagnosed with Type 2 DM for a duration of less than five years (41%). The economic crisis had a substantial influence on self-care practices, particularly on recommended dietary habits (76%), with females experiencing a notable impact than males (p= 0.027). Furthermore, the economic crisis had an impact on blood glucose testing (24%) and adherence to prescribed medications (22%). However, the crisis did not exert a significant effect on healthcare-seeking behaviour. The cost spend by the individuals for medication was decreased (p<0.001), and blood tests was increased (p<0.001) significantly after the economic crisis. Conclusions: These findings highlight the profound consequences of the economic crisis on DM patients’ ability to adhere to self-care practices and healthcare expenditure. However, the study establishes a baseline, and further research is needed to fully understand the burden of this issue.