METHODS: A quantitative online survey was conducted in Portugal, directed to parents of children under 5 years who had at least one LRTI in the previous year. The questionnaire aimed at characterizing the last LRTI considering health resources usage and OOP expenditure. Participants were recruited with the dissemination of the questionnaire link in some kindergartens (convenience samples) and on high engaged Instagram accounts.

RESULTS: 384 parents participated in the study, corresponding to 429 eligible children. 85% of these children were healthy (with no additional comorbidities) and 69% were 2 years or younger. These children had, on average, 2 LRTI per year. On average, parents spent 76.3€ in medical care (emergency visits, hospital admissions, pediatrics and general practitioners’ appointments) – due to NHS copayment and / or private practice payment. Parents spent 13.8€ in traveling and 41.4€ on health and wellness products. Other expenses (such as babysitters for siblings and meals) amounted at 17.8€. Overall, parents spent 149.3€ per infection. Annual OOP was estimated as 298.6 € per child. This OOP was similar (in absolute values) across different parents' income, but accounted for 5.3% of annual income in low income households and only 2.2% for higher income parents.