title: Estimating time and out-of-pocket costs incurred by families attending a pediatric cochlear implant programme.
abstract: OBJECTIVE
  The objectives of this study are to estimate time and out-of-pocket costs incurred by families attending a pediatric cochlear implant programme. In addition, qualitative data examine the intangible costs faced by families.
  
  
  METHODS
  Data was collected during semi-structured face-to-face interviews with parents of children with a cochlear implant attending a clinic visit at Nottingham Cochlear Implantation Programme (NPCIP), UK. Information supplied included socio-demographic characteristics, mode of travel, out-of-pocket expenses, time foregone, and details of companions. Quantitative data was stored and analysed in SPSS version 11.5.
  
  
  RESULTS
  Two hundred and sixteen face-to-face interviews were conducted with parents of children implanted for between 1 month and 13 years. Time and out-of-pocket costs were significantly higher for those in the first 2 years of the programme, mean UK pound 3090 per annum compared to UK pound 2159 per annum for those in years >2-5 and UK pound 1815 per annum for those in years >5 (P<0.001). The biggest component of this was time costs, although the sensitivity analysis revealed that these were also most variable depending on the methods used to estimate them. The largest out-of-pocket cost incurred by families was travel costs which accounted for 44%, although 16% of families received some financial help with travel costs. The qualitative findings are consistent with these findings, also showing that over time the financial and intangible costs incurred as a result of cochlear implantation decline.
  
  
  CONCLUSIONS
  This study is the first to obtain primary data on the time and out-of-pocket costs incurred by families attending a pediatric cochlear implant programme in the UK. It finds that these costs are greatest for those families in the first 2 years of the programme and/or who live furthest from the programme.
authors.affiliation: School of Community Health Sciences, B41 Medical School, Queen's Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK. tracey.sach@nottingham.ac.uk
authors.forename: T H
authors.initials: TH
authors.lastname: Sach
authors.forename: D K
authors.initials: DK
authors.lastname: Whynes
authors.forename: S M
authors.initials: SM
authors.lastname: Archbold
authors.forename: G M
authors.initials: GM
authors.lastname: O'Donoghue
mesh_terms: D000041:Absenteeism; D000328:Adult; D002648:Child; D002675:Child, Preschool; D019929:Cochlear Implantation / Q000191:economics*; D017281:Cost of Illness; D005260:Female; D005102:Health Expenditures; D006802:Human Activities / Q000191:economics; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012959:Socioeconomic Factors; D013997:Time Factors; D014186:Transportation / Q000191:economics; D006113:United Kingdom