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PEDIATRICS Vol. 103 No. 3 March 1999, pp. 556-564

Estimation of Direct and Indirect Costs Because of Common Infections in Toddlers Attending Day Care Centers

Received Mar 18, 1998; accepted Aug 13, 1998.

Hélène Carabin*, Theresa W. Gyorkos*, Dagger , Julio C. Soto§, John Penrodparallel , Lawrence Joseph*, Dagger , and Jean-Paul ColletDagger ,

From the * Department of Epidemiology and Biostatistics, McGill University; the Dagger  Division of Clinical Epidemiology, Montreal General Hospital; the § Régie régionale de la santé et des services sociaux de Laval, Laval; the parallel  Departments of Medicine and Economics, McGill University; and the  Centre for Clinical Epidemiology and Community Studies, Jewish General Hospital, Montréal, Québec, Canada.

Objective.    To describe both the direct and the indirect costs of illness in a closely followed cohort of toddlers attending day care centers (DCCs) in Québec, Canada.

Methods.    Fifty-two DCCs participated in the study. Parents were invited to fill in a calendar on which they would indicate the occurrence of colds, diarrhea, and vomiting, in addition to any actions taken with respect to this occurrence. The participating parents were called biweekly to report the information. The costs reported in this article are based on a period of 6 months of follow-up. The direct costs included medication and visits to a physician whereas indirect costs included alternative care provided by a family member, a babysitter, or an employed parent who missed work.

Results.    Two hundred seventy-three toddlers were followed from 35 to 182 days during the study period. During a 6-month period, the adjusted average costs per child for medication and consultation were $47.47 (standard deviation [SD] = 52.76) and $49.10 (SD = 51.34), respectively, whereas they amount to $11.51 (SD = 51.19) for care by a babysitter, $35.68 (SD = 94.74) for care by a family member, and $117.12 (SD = 210.29) for a parent missing work (when using opportunity cost). The overall adjusted average total costs per child incurred to the parents and society was $260.70 (SD = 301.25).

Conclusions.    The originality of this study was to comprehensively include all costs associated with the care of an ill child attending DCCs. Future research should aim at finding economical ways to decrease illness frequency in toddlers attending day care centers and subsequently the costs they incur.  Key words:  costs, day care center, infectious diseases, direct costs, indirect costs, toddlers, absenteeism.




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