Costs of Disabling Musculoskeletal Pain in Children and Adolescents: A Cost-Of-Illness Prospective Cohort Study

Abstract

OBJECTIVE: To (i) estimate the economic cost of disabling musculoskeletal pain in children and adolescents from a healthcare and societal perspective, (ii) identify the characteristics of children and adolescents with higher costs, and (iii) estimate the economic cost of children’s pain to Brazil. DESIGN: Prospective cohort study. METHODS: We recruited children and adolescents with disabling musculoskeletal pain from public and private schools. The economic cost associated with disabling musculoskeletal pain was reported by parents each month for 1 year. The cost categories were healthcare, lost productivity and patient/family costs. The sum of the categories resulted in the societal costs. Costs were reported using means, standard errors, medians, interquartile ranges, confidence intervals, and sum for each cost category. We compared participant characteristics between groups with low and high costs, and estimated the health and social cost of children’s pain to the Brazilian federal budget. RESULTS: We included 237 children and adolescents with mean age of 11.8 years (standard deviation 2.9). Total annual healthcare costs were USD29.58 and USD103.13 for health insurance/public healthcare and out-of-pocket respectively per child. Total annual societal costs were USD177.62 per child. Low socioeconomic class E (up to R$ 403.00 monthly), reported backpack weight as heavy, practice of fewer days of sports, and more negative psychosomatic symptoms were associated with higher healthcare costs. The annual costs to Brazil from the societal perspective was USD1,001,329,553. CONCLUSION: Disabling musculoskeletal pain in children and adolescents in Brazil imposes a serious economic burden of up to USD1 billion on the federal budget.