title: Labor market productivity costs for caregivers of children with spina bifida: a population-based analysis.
abstract: BACKGROUND
  Caregiver productivity costs are an important component of the overall cost of care for individuals with birth defects and developmental disabilities, yet few studies provide estimates for use in economic evaluations.
  
  
  OBJECTIVE
  This study estimates labor market productivity costs for caregivers of children and adolescents with spina bifida.
  
  
  METHODS
  Case families were recruited from a state birth defects registry in Arkansas. Primary caregivers of children with spina bifida (N = 98) reported their employment status in the past year and demographic characteristics. Controls were abstracted from the Current Population Survey covering the state of Arkansas for the same time period (N = 416). Estimates from regression analyses of labor market outcomes were used to calculate differences in hours worked per week and lifetime costs.
  
  
  RESULTS
  Caregivers of children with spina bifida worked an annual average of 7.5 to 11.3 hours less per week depending on the disability severity. Differences in work hours by caregivers of children with spina bifida translated into lifetime costs of $133,755 in 2002 dollars using a 3% discount rate and an age- and sex-adjusted earnings profile. Including caregivers' labor market productivity costs in prevention effectiveness estimates raises the net cost savings per averted case of spina bifida by 48% over the medical care costs alone.
  
  
  CONCLUSIONS
  Information on labor market productivity costs for caregivers can be used to better inform economic evaluations of prevention and treatment strategies for spina bifida. Cost-effectiveness calculations that omit caregiver productivity costs substantially overstate the net costs of the intervention and underestimate societal value.
authors: Center for Applied Research and Evaluation, College of Medicine, University of Arkansas for Medical Sciences and Arkansas Children's Hospital, Little Rock, AR. tilfordmickj@uams.edu
authors: John M
authors: JM
authors: Tilford
authors: Scott D
authors: SD
authors: Grosse
authors: Allen C
authors: AC
authors: Goodman
authors: Kemeng
authors: K
authors: Li
mesh_terms: D000293:Adolescent; D000368:Aged; D001131:Arkansas; D017028:Caregivers / Q000191:economics*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D017598:Efficiency, Organizational; D004651:Employment / Q000191:economics*; D006801:Humans; D018803:Models, Economic; D012042:Registries; D012044:Regression Analysis; D012720:Severity of Illness Index; D016135:Spinal Dysraphism / Q000191:economics*