Infectious illnesses of young children: financial burden for rich countries - a literature review
Abstract While childcare assistance has indisputable positive effects on female employment and economic growth, children attending day care centres show a considerably higher number of infections compared to those raised at home. This is not only a substantial threat to the well-being of families, but also a major economic burden for society. This review aims at examining studies that describe and quantify the costs of illnesses that are possibly transmitted in kindergarten to enable development of policies and interventions. A scientific literature search was performed. The electronic databases PubMed and Medline were searched with keywords and MeSH terms (Cost of Illness; Health Care Costs; Child). Articles were considered relevant, if published after the year 2000 in English, if conducted in Europe, USA or Australia, examining contagious illnesses (respiratory, influenza(-like), gastrointestinal diseases) of children and if not solely focused on hospitalization costs. A total of 504 records were identified. After abstract and full text screening, 15 articles were selected. No article summarizes all illnesses that are possibly transmitted in kindergarten, studies rather estimate costs for one diagnosis or one symptom group only. Main cost buckets considered are direct medical, direct non-medical and indirect costs (mainly due to loss of workdays of caregivers). Focus and perspective of the studies and thus the quantification of costs differs widely (e.g., for respiratory illnesses per non-hospitalized case one study claims 123 vs. 49 Euro in neighbouring countries). Existing cost of illness studies cannot easily be combined to one overall cost estimation for sick kindergarten children, which is needed to foster public health actions and to enable cost-efficient design. However, solely looking at single illnesses already reveals the big potential which comes with reducing contagious illnesses in the child age and thus, the urgent need to action to relieve children and society. Key messages The economic burden arising from contagious illnesses among kindergarten children is substantial and reveals the need for policies and interventions to relieve children and society. Further research is needed to get a comprehensive view of cost of illnesses for children with illnesses transmitted in kindergarten to enable cost-efficient design of interventions.