title: Health and economic benefits of reducing the number of students per classroom in US primary schools.
abstract: OBJECTIVE
  We estimated the costs associated with reducing class sizes in kindergarten through grade 3 as well as the effects of small class sizes on selected outcomes such as quality-adjusted life-years and future earnings.
  
  
  METHODS
  We used multiple data sets to predict changes in the outcomes assessed according to level of educational attainment. We then used a Markov model to estimate future costs and benefits incurred and quality-adjusted life-years gained per additional high school graduate produced over time.
  
  
  RESULTS
  From a societal perspective (incorporating earnings and health outcomes), class-size reductions would generate a net cost savings of approximately $168,000 and a net gain of 1.7 quality-adjusted life-years for each high school graduate produced by small classes. When targeted to low-income students, the estimated savings would increase to $196,000 per additional graduate. From a governmental perspective (incorporating public expenditures and revenues), the results of reducing class sizes ranged from savings in costs to an additional cost of $15000 per quality-adjusted life-year gained.
  
  
  CONCLUSIONS
  Reducing class sizes may be more cost-effective than most public health and medical interventions.
authors: Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. pm124@columbia.edu
authors: Peter
authors: P
authors: Muennig
authors: Steven H
authors: SH
authors: Woolf
mesh_terms: D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D003362:Cost-Benefit Analysis; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D015233:Models, Statistical; D009010:Monte Carlo Method; D019057:Quality-Adjusted Life Years; D012107:Research Design; D012574:Schools / Q000706:statistics & numerical data*; D013334:Students / Q000706:statistics & numerical data*; D014481:United States