73 Burden of Prenatal Exposure to Alcohol: Measurement of Costs
Bibliographic record
Abstract
In Canada, the incidence of Fetal Alcohol Spectrum Disorder (FASD) has been estimated to be 1 to 6 in 1000 live births. Caused by prenatal exposure to alcohol, FASD is the leading cause of developmental and cognitive disabilities among Canadian children and its effects are life lasting. This study examined the necessity of allocating funds to FASD prevention and treatment programs by articulating the economic costs of prenatal exposure to alcohol. The current research addressed a gap in knowledge as analyses of costs to-date have calculated only partial costs associated with the disorder, reflecting gross underestimates of the true cost of FASD, and no study has been conducted in a Canadian setting. To estimate direct and indirect costs associated with FASD at the individual level. Research Design: A cross-sectional study design was used. Sample and Setting: One-hundred and forty-eight (148) parents of children with FASD, ages 1 to 21 years, living in urban and rural communities throughout Canada participated in the study. Procedure: Participants completed the Health Services Utilization Inventory (HSUI). The interviewer administered HSUI is a 25 page inventory designed to elicit direct and indirect costs associated with FASD. Key cost components were measured: direct costs: medical, education, social services, out-of-pocket costs; and indirect costs: productivity losses. Total costs were calculated at the patient level by summing the costs for each child in each cost component, and dividing by the sample size. A stepwise multiple regression analysis was used to identify factors that impacted on cost, and to calculate the adjusted annual costs associated with FASD. Total adjusted annual costs associated with FASD per child were $14,342 (95% CI, $12,986; $15,698). Severity of the child's condition, age of the child, and geographical setting significantly impacted on costs (p<0.001). The cost of FASD annually to Canada of those 1 to 21 years old, was $344,208,000 (95% CI $311,664,000; $376,752,000). The study results demonstrated that the profound cost burden of prenatal exposure to alcohol. Implications for practice, policy, and research are discussed.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.014 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".