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. 2020 Feb 17;102(4):731–739. doi: 10.4269/ajtmh.19-0721

Table 3.

Direct and indirect costs (US$) for households with children younger than 12 months hospitalized with severe pneumonia (N = 87)

N* Mean/proportion Median† SD Minimum Maximum
I. Direct costs
A. Medical
 Diagnostics 15 42.7 14.0 45.3 6.0 154.0
 Medications 37 14.8 11.0 13.9 1.6 70.5
 Treatments 55 10.0 8.9 10.4 0.0 71.0
 Bed charges/hospital admissions 2 3.3 3.3 0.4 3.0 3.5
Mean of direct medical costs‡ 62 27.6 14.8 35.7 2.0 166.9
B. Nonmedical
 Transportation 70 3.7 1.0 8.1 0.0 52.0
 Food and lodging§ 30 12.6 10.0 5.1 1.0 20.0
 Communication‖ 79 2.5 1.8 2.5 0.1 15.0
 Care of other children 3 20.0 20.0 8.2 10.0 30.0
 Miscellaneous household tasks 8 32.3 29.3 21.8 10.0 80.0
Mean of direct nonmedical costs¶ 87 13.5 8.0 16.5 0 93.6
Mean: direct costs# 87 33.1 23.8 37.7 1.0 204.5
II. Indirect costs
 Lost earnings 30 64.3 41.3 61.3 10.0 240.0
 Opportunity cost of lost time** 21 34.4 30.4 38.2 3.8 172.9
  Opportunity cost of time, +50%†† 51.6 45.6 57.3
  Opportunity cost of time, −50%†† 17.2 15.2 19.1
Mean: indirect costs‡‡ 43 61.5
Mean of total costs 87 49.7 44.5 39.8 0 239.9

* N is the number of households of the total sample of 87 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.

‡ Participants who reported at least one direct medical cost are included in this calculation. A total of n = 19 participants reported no direct medical costs.

§ Includes 23 children younger than 12 months who were given a $10 subsidy and four children younger than 12 months who were given a $20 subsidy to cover food/accommodation.

‖ Includes 29 children younger than 12 months who were given a $1.80 subsidy for communication.

¶ Participants who reported at least one direct nonmedical cost are included in this calculation. A total of n = 8 participants reported no indirect medical costs.

# Participants who reported at least one direct medical or one direct nonmedical cost are included in this calculation. A total of n = 3 participants reported no direct costs.

** 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 this calculation. A total of n = 44 participants reported no such indirect cost.