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ORIGINAL RESEARCH article

Front. Public Health

Sec. Health Economics

Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1589114

The Economic and Social Burden of Pediatric Cerebral Palsy in Spain: A Cost-of-Illness Study

Provisionally accepted
  • 1Public University of Navarre, Pamplona, Spain
  • 2Complejo Hospitalario de Navarra, Pamplona, Navarre, Spain

The final, formatted version of the article will be published soon.

Background: Cerebral palsy (CP) is the leading cause of motor disability in children and a lifelong condition with no cure, imposing a significant economic burden on families and healthcare systems. However, the economic impact of pediatric CP remains underexplored in Spain, hindering the development of cost-effective policies. Cost-of-illness (COI) studies are essential to quantify disease burden and guide resource allocation. This study aims to classify and estimate the economic and social costs of pediatric CP in Spain from a societal perspective, considering healthcare, government, and family burdens. Additionally, it evaluates the caregiving burden experienced by primary caregivers.Methods: A bottom-up, disease-specific COI study was conducted from a societal perspective using data from a population-based epidemiological registry of CP. Data collection included structured questionnaires and administrative records from regional healthcare and government sources, covering a one-year period. The Zarit Burden Interview was used to assess caregiver burden. The study captures direct, indirect, and out-of-pocket costs, including productivity losses associated with caregiving.Results: The study included 148 children with CP (mean age: 9.72) and their primary caregivers (66% female, mean age: 42.97 years). Medical care costs averaged €3,801 (3.72%), while out-of-pocket expenses totalled €7,041 (6.89%), largely driven by complementary and alternative therapies used by 64% of families. Special education represented €8,932 (8.75%), whereas caregiver productivity losses were the largest component (€60,638; 59.37%). The mean annual societal cost per child was €102,135, over thirty times Spain’s mean per capita healthcare expenditure. However, using a conservative assumption that valued the caregiver’s time at the minimum wage, the social costs would be €70,190 per child. Children with severe motor impairment (GMFCS III–V) had nearly twice the cost of those with milder impairments (GMFCS I–II) (1.96; 95% CI: 1.92–2.01).Conclusions: The economic burden of pediatric CP is largely driven by caregiving and non-medical costs, highlighting gaps in financial and social support. These findings call for targeted policies to reduce caregiver strain and enhance funding for assistive services, improving equity in CP care. Additionally, comprehensive cost-effectiveness analyses are needed to guide resource allocation and ensure sustainable support strategies

Keywords: Cost of Illness, economic burden, Cerebral Palsy, Social costs, caregiver burden, Healthcare costs

Received: 06 Mar 2025; Accepted: 30 Jun 2025.

Copyright: © 2025 Nova Diaz, Arana Rivera, Sánchez Iriso and Aguilera-Albesa. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Diana Marcela Nova Diaz, Public University of Navarre, Pamplona, Spain

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