Table 2.
Direct and indirect costs (US$) for households with child hospitalized with severe pneumonia
| N* | Mean/proportion | Median† | SD | Minimum | Maximum | |
|---|---|---|---|---|---|---|
| I. Direct costs | ||||||
| A. Medical | ||||||
| Diagnostics | 20 | 35.9 | 16.0 | 41.0 | 2.5 | 154.0 |
| Medications | 57 | 14.5 | 11.0 | 12.9 | 2.0 | 50.0 |
| Treatment‡ | 89 | 8.7 | 7.2 | 8.9 | 0.0 | 71.0 |
| Bed charges/hospital admissions | 4 | 10.4 | 9.25 | 8.5 | 3.0 | 20.0 |
| Mean of direct medical costs§ | 96 | 23.5 | – | – | – | – |
| B. Nonmedical | ||||||
| Transportation‖ | 123 | 4.8 | 1.0 | 11.1 | 0.0 | 80.0 |
| Food and lodging¶ | 86 | 12.0 | 10.0 | 5.8 | 2.0 | 40.0 |
| Communication# | 142 | 3.0 | 1.8 | 2.9 | 0.1 | 15.0 |
| Care of other children** | 8 | 33.1 | 25.0 | 29.0 | 0.0 | 100.0 |
| Miscellaneous household tasks | 11 | 44.5 | 33.0 | 38.0 | 10.0 | 150.0 |
| Mean of direct nonmedical costs†† | 153 | 18.3 | 12.3 | 24.4 | 0.0 | 165.0 |
| Mean: direct costs‡‡ | 153 | 33.0 | – | – | – | – |
| II. Indirect costs | ||||||
| Lost earnings | 57 | 79.0 | 45.0 | 77.2 | 3.0 | 300.0 |
| Opportunity cost of lost time§§ | 29 | 36.8 | 28.5 | 40.5 | 3.8 | 171.0 |
| Opportunity cost of time, +50%‖‖ | – | 55.2 | 42.8 | – | – | – |
| Opportunity cost of time, −50%‖‖ | – | 18.4 | 14.3 | – | – | – |
| Mean: indirect costs¶¶ | 75 | 74.3 | – | – | – | – |
| Mean of total costs | 153 | 49.5 | 44.7 | 39.1 | 0.0 | 239.9 |
* N is the number of households of the total sample of 153 that reported a specific cost item of ≥ $0, unless otherwise explained (excludes missing values only). For any categories in which the mean cost between households that reported a cost > $0 and households reporting a cost ≥ $0 was greater than 10%, the values for the former are provided in footnotes.
† The median is also reported because of SDs that are higher than the mean.
‡ Among households that reported > $0 costs for treatment (n = 86), mean = 9.0, median = 7.4, SD = 8.8, minimum = .11, and maximum = 71.0.
§ Participants who reported at least one direct medical cost are included in this calculation. A total of n = 57 participants reported no direct medical costs.
‖ Includes one child older than 12 months who was given a $21 subsidy to cover transportation to another hospital.
¶ Includes 70 households that were given a subsidy as part of the study to cover food/lodging; 11 households were given $20 and 59 were given $10.
# Includes 58 households that were given a communication subsidy of $1.80.
** Among households that reported >$0 costs for care of other children (n = 7), mean = 37.0, median = 30.0, SD = 28.0, minimum = 10.0, and maximum = 100.0.
†† Participants who reported at least one direct nonmedical cost, including those given subsidies, are included in this calculation (N = 153).
‡‡ Participants who reported at least one direct medical or one direct nonmedical cost are included in this calculation (N = 153).
§§ The opportunity cost of lost time, representing the value of caregivers’ time that otherwise would have been spent engaging in normal daily unpaid activities, was estimated by t × V, where t represents the amount of time lost and V represents the value of lost time. t was based on the time (in hours) reported by caregivers, which was converted to working days (8 hours/day); V was estimated using the unskilled labor wage in Ecuador (US$1.90/hour); this value was calculated from the International Labour Organization’s average monthly earnings of employees in Ecuador ($323 per month) in 2010 when the study was conducted.
‖‖ Given the variability in wages across Ecuador, we conducted additional sensitivity analyses to estimate the opportunity cost of lost time, given minimum and maximum ranges of ± 50% for V.
¶¶ Participants who reported any lost earnings or lost time were included in these calculations. A total of n = 78 participants reported no such indirect cost.