THE BURDEN OF PRENATAL EXPOSURE TO ALCOHOL: MEASUREMENT OF COST

Abstract

Background In Canada the incidence of Fetal Alcohol Spectrum Disorder (FASD) is estimated at 1 to 6 in 1000 live births. FASD is the leading cause of developmental and cognitive disabilities among Canadian children. There is a paucity of research examining the economic costs of FASD. Objective To estimate direct and indirect costs associated with FASD at the patient level. Methods Design: Cross-sectional study design was used. Sample and Setting: One-hundred and forty-eight (148) parents of children with FASD, aged 1 to 21 years, living in urban and rural communities throughout Canada. Procedure: Participants completed the Health Services Utilization Inventory (HSUI). Key cost components were elicited: direct costs: medical, education, social services, out-of-pocket costs; and indirect costs: productivity losses. Data Analysis: Total average costs per child were calculated by summing the costs for each child in each cost component, and dividing by the sample size. Costs were extrapolated to one year. A stepwise multiple regression analysis was used to identify significant determinants of costs and to calculate the adjusted annual costs associated with FASD. Results Total adjusted annual costs associated with FASD per child were $14,342 (95% CI, $12,986; $15,698). Severity of the child’s condition, age of the child, and geographical setting were significant determinants of costs (p < 0.001). Cost of FASD annually to Canada of those 1 to 21 years old, was $344,208,000 (95% CI $311,664,000; $376,752,000). Conclusions Study results demonstrated the cost burden of FASD was profound. Implications for practice, policy, and research are discussed.