OBJECTIVES: There is a plethora of evidence indicating that health care costs are rising. However, little is known surrounding out-of-pocket (OOP) costs and productivity losses downloaded to parents of children requiring emergency care. This study aimed to explore the OOP costs and time/productivity losses for parents of children presented in the emergency department (ED) and underwent resuscitation in five Niagara hospitals.

METHODS: A qualitative research design is embedded in an ongoing larger economic evaluation of the Pediatric Tele-resuscitation Program. Using a purposive sampling approach, five in-depth virtual interviews were conducted with parents of children admitted to EDs from December 2018 to November 2021. Interviews were audio-recorded and verbatim transcripts were analyzed using deductive content analysis and inductive thematic analysis.

RESULTS: All children (n=5) received initial care and resuscitation at ED and later transferred to a tertiary-level children’s hospital located outside the Niagara region. Emerging themes indicate substantial financial burden for expenses per child related to transportation (average $435.44), accommodation (n=1, 120$), and food (average $80). Since children were hospitalized away from their home community, one parent was required to remain onsite. In one scenario, 40 hours of work were missed and resulted in approximately $800 missed wages.

CONCLUSION: Our findings, albeit limited by the small number of participants, identified important OOP costs and time/productivity losses for critically ill children in the Niagara Region. Due to proximity between tertiary hospital and patients’ home; parents often commuted to the hospital multiple times instead of paying for accommodations. Hence, a large travel costs on average. More research is needed to understand the economic consequences of psychosocial and health outcomes among these children.