The Cost of Otitis Media

The cost of not breastfeeding to the health care system and to families can be a strong societal force to increasing public support for breastfeeding. Recently several articles have appeared in scientific journals to document the total cost of otitis media (OM).

In the US, Gates¹ (not the Billionaire) has estimated the overall cost of OM to be $US2 to 3.5 billion annually. In the US where private medical insurance pays the bills, expenditures for common ailments are routinely scrutinized. As OM is a common childhood illness, its cost comprises a substantial portion of the healthcare dollar; as well, indirect costs born by families -- sick days, trips to doctors, medications need to be included into the accounting.

In Finland 43 per cent of children have had 4 or more OM attacks, 35 per cent have had 1 to 3 attacks and 22 per cent have had none by the age of five years. Treatment is by antibiotics and usually one physician visit. Niemela² and colleagues determined the direct (medical) and indirect (family) costs in a Finnish day care population of 736 children. The direct costs included the physician visits, adenoidectomies, tube insertions and medications. Indirect costs were calculated from travel costs and productivity loss from parental work absence. Their calculations came up with $US228. per episode of OM with an average cost per child under the age of two years at $US1040. In all the total annual cost was determined to be $US138 million in the Finnish population of 5 million.

Alsarraf and Gates3 note that the actual indirect costs to parents is considerably higher than accounted for in the Finnish data. They state that the value of parental time, especially the unpaid time of parental care makes up about 87 per cent of the total indirect costs. When these are included into the tabulation, the real cost of a single episode of OM is $US1330. These figures still do not account for the long term costs of language and cognitive impairment related to OM.

Funds put towards prevention to increase breastfeeding rates is a very efficient and cost effective means to reduce both societal and family cost.

References:
1. Gates, G.A. Cost-effectiveness considerations in otitis media treatment. Otolaryngol Head Neck Surg 114: 525-530, 1996 BACK
2. Niemela, M. et al. Costs arising from otitis media. Acta Pediatr 88: 553-556, 1999 BACK
3. Alsarraf, R. Gates, G.A. The real cost of otitis media. Acta Pediatr 88: 487-488, 1999 BACK