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Costos Económicos del Síndrome de Alcoholismo Fetal » El
Impacto Financiero del SAF » Apéndice
Apéndice
Theoretical Issues Relevant to Estimating Costs of FAS
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Theoretical Issue
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Brief Description
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How are "costs" defined? Are the costs public, private, or both?
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Typically, economists' definition of cost is based on the concept of the alternative
use of a scarce resource, or opportunity cost. In addition, both tangible and intangible
costs (e.g., pain and suffering) can be estimated, although the latter is rarely
valued in health studies. Further, public and private costs can be estimated; social
costs include both.
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Should one use incidence-based or prevalence-based estimates of costs?
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An incidence-based approach uses an estimate of expected lifetime costs for new
cases to estimate present and future costs. A prevalence-based approach generally
measures the current year costs based on new cases and previously existing cases.
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Are productivity losses included?
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Some cost estimates include an amount for productivity losses associated with an
illness.
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Are administrative, prevention, research, and education costs included?
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While such costs are associated with programs that serve individuals with FASD,
they are often viewed as policy costs rather than direct costs. However, policy
costs are generally included in the general cost-of-illness framework.
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Are juvenile/criminal and law enforcement costs included?
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While a link between FASD and involvement with the juvenile/criminal justice system
may exist, the causal connection has not yet been rigorously studied.
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Should nonworkforce morbidity and mortality costs be included? How?
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It is possible to estimate the cost of unpaid work (e.g., child care) and the cost
of persons to provide replacement services. However, such studies have not been
conducted to date.
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What value is placed on life itself?
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While it is troublesome to many to place a dollar value on life (or quality years
of life), for some cost estimation studies, the absence of any value on life or
quality years is not reasonable either. Economists have used human capital (value
of lost productivity) and willingness to pay to address this issue.
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How Well-Documented FAS Cost Estimates Address Theoretical Issues
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Theoretical Issue
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Abel and Sokol
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Harwood and Napolitano
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Rice, et al.
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Harwood, et al.
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Are the costs public, private, or both?
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Both; treatment costs can be public or private.
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Both; treatment costs can be public or private.
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Both; treatment costs can be public or private.
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Both; treatment costs can be public or private.
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Are cost estimates based on incidence or prevalence?
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Prevalence
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Prevalence
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Prevalence
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Prevalence
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Are productivity losses included?
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No
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Yes
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No
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Yes
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Are administrative, prevention, research, and education costs included?
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No
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No
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Only research
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Not broken out for FAS, but included in the total cost of alcohol disorders
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Are juvenile/criminal and law enforcement costs included?
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No
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No
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No
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No
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Are nonworkforce morbidity and mortality costs included?
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No
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No
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No
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No
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Is a value placed on life itself?
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No
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Addressed via lost productivity
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No
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Addressed via lost productivity
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