The total value of time of children undergoing treatment: A contingent valuation from the perspective of parents in the orthopaedic department of a Dutch hospital

J Paediatr Child Health. 2019 May;55(5):539-547. doi: 10.1111/jpc.14236. Epub 2018 Oct 11.


Aim: Children spend substantial amounts of time receiving medical care (patients' time), and this patients' time plays an important role in parental choices for paediatric care. However, it is usually ignored in economic evaluations. This is a concern because economic evaluations are increasingly being used to inform child health policy decision-making. This study aims to quantify the time children spend receiving medical care and attach a monetary value to it for use in economic evaluations. It applied the parents' perspective. Consequently, the derived money values are the time values for both child and the accompanying parent.

Methods: We used the contingent valuation methodology. We collected data on 83 children undergoing orthopaedic treatment in a Dutch hospital. Accompanying parents were asked to quantify and value the patients' time of their children. We separately explored travel, waiting and treatment time. We also checked whether the monetary valuation varied across parents' financial situation, children's health and level of pain.

Results: Parents were willing to pay about €33 (confidence interval (CI) 21.2-48.1) for a 1-day reduction in treatment time; about €11.5 (CI 4.2-19.1) for an hour's reduction in waiting time; and about €4.5 (CI 1.5-7.4) for an hour's reduction in travel time. In addition, respondents with better financial conditions have, on average higher, willingness to pays.

Conclusions: To our knowledge, this is the first instance that patients' time of children has been monetarily valued. This methodology can be used to further develop economic evaluations of paediatric care and could be applied to larger samples with varying clinical conditions.

Keywords: contingent valuation method; cost-effectiveness analysis; economic evaluation; orthopaedic care; paediatric care; valuation of patients' time of children.

MeSH terms

  • Adolescent
  • Child
  • Child Welfare
  • Child, Preschool
  • Cost-Benefit Analysis
  • Databases, Factual
  • Emergency Service, Hospital / economics*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Hospital Costs*
  • Hospitalization / economics*
  • Hospitalization / statistics & numerical data
  • Humans
  • Incidence
  • Length of Stay / economics*
  • Male
  • Netherlands
  • Orthopedic Procedures / economics
  • Orthopedic Procedures / statistics & numerical data*
  • Retrospective Studies
  • Risk Assessment
  • Time Factors
  • Wounds and Injuries / diagnosis
  • Wounds and Injuries / economics
  • Wounds and Injuries / therapy*