The economic and social burden of pediatric cerebral palsy in Spain: a cost-of-illness study

Nova Díaz, Diana Marcela; Arana-Rivera, Paloma; Sánchez Iriso, Eduardo; Aguilera Albesa, Sergio

The economic and social burden of pediatric cerebral palsy in Spain: a cost-of-illness study

dc.contributor.author	Nova Díaz, Diana Marcela
dc.contributor.author	Arana-Rivera, Paloma
dc.contributor.author	Sánchez Iriso, Eduardo
dc.contributor.author	Aguilera Albesa, Sergio
dc.contributor.department	Ciencias de la Salud	es_ES
dc.contributor.department	Osasun Zientziak	eu
dc.contributor.department	Economía	es_ES
dc.contributor.department	Ekonomia	eu
dc.contributor.funder	Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
dc.contributor.funder	Gobierno de Navarra / Nafarroako Gobernua
dc.date.accessioned	2025-08-05T09:08:25Z
dc.date.available	2025-08-05T09:08:25Z
dc.date.issued	2025-07-23
dc.date.updated	2025-08-05T09:02:24Z
dc.description.abstract	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 costeective 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 1-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 e3,801 (3.72%), while out-of-pocket expenses totalled e7,041 (6.89%), largely driven by complementary and alternative therapies used by 64% of families. Special education represented e8,932 (8.75%), whereas caregiver productivity losses were the largest component (e60,638; 59.37%). The mean annual societal cost per child was e102,135, 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 e70,190 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-eectiveness analyses are needed to guide resource allocation and ensure sustainable support strategies.	en
dc.description.sponsorship	The author(s) declare that financial support was received for the research and/or publication of this article. This work was funded by the Public University of Navarra and Banco Santander through a pre-doctoral grant awarded to the main author. Additionally, the project of which this study forms part received funding from the Department of Health of Navarra (Resolution 1068/2024; Reference: 35/24 - Gobierno de Navarra), within the framework of the Study of Cerebral Palsy in the Pediatric Age in Navarra (EPCINA).
dc.format.mimetype	application/pdf
dc.format.mimetype	application/msword
dc.identifier.citation	Nova Diaz, D. M., Arana-Rivera, P., Sánchez-Iriso, E., Aguilera-Albesa, S. (2025). The economic and social burden of pediatric cerebral palsy in Spain: a cost-of-illness study. Frontiers in Public Health, 13, 1-20. https://doi.org/10.3389/fpubh.2025.1589114.
dc.identifier.doi	10.3389/fpubh.2025.1589114
dc.identifier.issn	2296-2565
dc.identifier.uri	https://academica-e.unavarra.es/handle/2454/54592
dc.language.iso	eng
dc.publisher	Frontiers Media
dc.relation.ispartof	Frontiers in Public Health. (2025), vol. 13
dc.relation.projectID	info:eu-repo/grantAgreement/Gobierno de Navarra//35%2F24/
dc.relation.publisherversion	https://doi.org/10.3389/fpubh.2025.1589114
dc.rights	© 2025 Nova-Díaz, 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).
dc.rights.accessRights	info:eu-repo/semantics/openAccess
dc.rights.uri	https://creativecommons.org/licenses/by/4.0/
dc.subject	Cost of illness	en
dc.subject	Economic burden	en
dc.subject	Cerebral palsy	en
dc.subject	Social costs	en
dc.subject	Caregiver burden	en
dc.subject	Healthcare costs	en
dc.title	The economic and social burden of pediatric cerebral palsy in Spain: a cost-of-illness study	en
dc.type	info:eu-repo/semantics/article
dc.type.version	info:eu-repo/semantics/publishedVersion
dspace.entity.type	Publication
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