Measuring the financial burden of acute cough in pre-school children: a cost of illness study

BACKGROUND CONTEXT Acute cough is a very common symptom presentation among children in primary care and is usually due to respiratory infection, yet its cost is unknown. An estimate of the cost to healthcare providers and parents would aid budgetary decision-making, and provide an insight into the need for interventions to reduce the burden. PURPOSE To estimate the cost per child per episode, and the annual population cost in the UK, of acute cough in pre-school children presenting to primary care. METHODS DESIGN Incidence and prevalence-based cost-of-illness study from the perspectives of the UK NHS and of parents and caregivers. SETTING 11 general practices in Bristol, UK. SUBJECTS 121 children without known asthma aged 3 to 59 months presenting for the first time with an acute (</= 28 days) cough. RESULTS Mean cost per episode to the NHS: pound27.43 (95% CI: pound24.38 - pound30.49). Mean cost per episode to parents and carers: pound14.77 ( pound4.90 - pound24.65). Annual cost to the NHS in the UK: at least pound31.5 m (95% CI: pound28.0 m - pound35.0 m). CONCLUSION The cost burden on the healthcare provider of acute cough in pre-school children is substantial; the majority of this cost arises from consultations with general practitioners. Parents experience some personal cost through travel and expenditure on over-the-counter preparations, and may suffer significantly if loss of earnings is experienced. There is scope for evaluating interventions designed to reduce this burden.