{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T15:36:51Z","timestamp":1785771411876,"version":"3.56.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T00:00:00Z","timestamp":1776816000000},"content-version":"vor","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross\u2010sectional cost\u2010of\u2010illness 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2009h) and at the facility (2.4\u2009h) 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\u201359 years), unemployment, and lack of tertiary education significantly increased CHE risk, while NHIS enrollment reduced risk at higher thresholds.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hsr2.72417","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T05:11:23Z","timestamp":1776921083000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Economic Burden of Type 2 Diabetes Mellitus Among Patients Attending Ho Teaching Hospital in the Ho Municipality, Ghana: A Cross\u2010Sectional Study"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7101-769X","authenticated-orcid":false,"given":"Maxwell Ayindenaba","family":"Dalaba","sequence":"first","affiliation":[{"name":"Institute of Health Research University of Health and Allied Sciences Ho Volta Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phidelia Theresa","family":"Doegah","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Health and Allied Sciences Ho Volta Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustapha","family":"Immurana","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Health and Allied Sciences Ho Volta Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Kaba","family":"Alhassan","sequence":"additional","affiliation":[{"name":"Institute of Health Research University of Health and Allied Sciences Ho Volta Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Welaga","sequence":"additional","affiliation":[{"name":"School of Public Health C.K. Tedam University of Technology and Applied Sciences Navrongo Upper East Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel Adurayi","family":"Amenah","sequence":"additional","affiliation":[{"name":"Social Science Department Ghana College of Physicians and Surgeons Accra Greater Accra Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaiah Awintuen","family":"Agorinya","sequence":"additional","affiliation":[{"name":"FNB School of Public Health University of Health and Allied Sciences hohoe Volta Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin Amogre","family":"Ayanore","sequence":"additional","affiliation":[{"name":"FNB School of Public Health University of Health and Allied Sciences hohoe Volta Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Amuna","sequence":"additional","affiliation":[{"name":"FNB School of Public Health University of Health and Allied Sciences hohoe Volta Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William Kofi","family":"Bosu","sequence":"additional","affiliation":[{"name":"FNB School of Public Health University of Health and Allied Sciences hohoe Volta Region Ghana"},{"name":"School of Biomedical Sciences University of Cape Coast Cape Coast Central Region Ghana"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,22]]},"reference":[{"key":"e_1_2_15_2_1","volume-title":"Type 2 Diabetes","author":"Goyal R.","year":"2025"},{"key":"e_1_2_15_3_1","unstructured":"WHO. \u201cDiabetes \u201d 2024 https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/diabetes."},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-14-1069"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.4314\/ahs.v23i3.38"},{"key":"e_1_2_15_6_1","unstructured":"WHO \u201cGhana on the Offensive Against Diabetes | WHO | Regional Office for Africa \u201d 2023 https:\/\/www.afro.who.int\/countries\/ghana\/news\/ghana-offensive-against-diabetes."},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-019-01144-7"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0327610"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0165151"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3249-9"},{"issue":"5","key":"e_1_2_15_11_1","first-page":"367","article-title":"Economic Burden of Type 2 Diabetes Mellitus Complications Among Patients in the Eastern Region of Ghana: A Descriptive Cross\u2010Sectional Cost\u2010of\u2010Illness Study","volume":"7","author":"Aikins S. 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