Costs of Receiving Developmental Services for Children With Global Developmental Delay at Siriraj Hospital in Bangkok, Thailand

Objectives: To identify the cost from the societal, caregiver, and hospital perspectives for receiving developmental services for children with global developmental delay (GDD) at Siriraj Hospital. Methods: This descriptive study collected data from children under 5 years old with GDD from November, 2021 to October, 2022. The hospital's perspective cost and caregivers’ direct medical costs were obtained from the Siriraj database. Caregivers were interviewed about their expenses for direct nonmedical and indirect costs. Caregivers and hospital perspective costs were summed to total societal perspective. Results: Of the 100 caregivers, most (39%) of their children had Universal Coverage; however, 22% of the caregivers decided not to use any healthcare coverage. The median annual cost of the societal perspective was 209.81 (range 14.51-2134.08) US dollar (USD)/child. Median annual caregiver's perspective, direct medical, direct nonmedical and indirect costs were 119.82 (range 9.20-2068.91), 0 (range 0-231.89), 68.96 (range 2.87-2068.91), and 0 (range 0-1293.07) USD/child, respectively. The mean proportion of the expenses of each child among direct medical, direct nonmedical, and indirect costs was 11:71:18. The median annual hospital perspective cost was 71.38 (range 5.17-807.13) USD/child. Conclusion: The annual societal economic burden for each Thai child with GDD was 209.81 USD. The direct nonmedical cost, especially transportation, was the largest proportion of the total cost from the caregiver's perspective. Effective referral system, proper specialist allocation throughout the country, and developing of the service system are crucial for the alleviation of this burden.