Abstract
Childhood illness is extremely common and imposes a considerable economic burden on society. We aimed to quantify the overall economic burden of childhood illness in the first three years of life and the impact of environmental risk factors. The study is based on the prospective, clinical mother–child cohort Copenhagen Prospective Studies on Asthma in Childhood (COPSAC2010) of 700 children with embedded randomized trials of fish-oil and vitamin D supplementations during pregnancy. First, descriptive analyses were performed on the total costs of illness, defined as both the direct costs (hospitalizations, outpatient visits, visit to the practitioner) and the indirect costs (lost earnings) collected from the Danish National Health Registries. Thereafter, linear regression analyses on log-transformed costs were used to investigate environmental determinants of the costs of illness. The median standardized total cost of illness at age 0–3 years among the 559 children eligible for analyses was EUR 14,061 (IQR 9751–19,662). The exposures associated with reduced costs were fish-oil supplementation during pregnancy (adjusted geometric mean ratio (GMR) 0.89 (0.80; 0.98), p = 0.02), gestational age in weeks (aGMR = 0.93 (0.91; 0.96), p < 0.0001), and birth weight per 100 g (aGMR 0.98 (0.97; 0.99), p = 0.0003), while cesarean delivery was associated with higher costs (aGMR = 1.30 (1.15; 1.47), p < 0.0001). In conclusion, common childhood illnesses are associated with significant health-related costs, which can potentially be reduced by targeting perinatal risk factors, including maternal diet during pregnancy, cesarean delivery, preterm birth and low birth weight.
Highlights
Childhood illness is very common in the general population, in the first three years of life [1]
We have previously shown in a randomized controlled trial (RCT) that maternal fish-oil supplementation in pregnancy reduces the risk of asthma and lower respiratory tract infections in childhood [8,9]
Of the 700 children included in the COPSAC2010 mother–child cohort, we excluded children who did not complete the first 3 years of the study, children with less than 90% of the daily diary registrations and children not registered in the National Danish Register, leaving 559 (80%) eligible children for analysis (Figure S1)
Summary
Childhood illness is very common in the general population, in the first three years of life [1]. Other common childhood illnesses include allergies, skin problems, eye conditions, neurological issues and gastrointestinal conditions. The majority of these illnesses are mild and treated, often without or with very brief healthcare contact, but due to their high frequency, they constitute a sizeable economic burden to society due to healthcare utilization and parents’ work absenteeism [1]. No studies have dealt with the total costs of common childhood illnesses, including nonsevere self-limiting infections, which are not studied in larger populations, since they often do not require visits to medical facilities, but can be treated at home
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