OBJECTIVES:  Families often incur significant out-of-pocket (OOP) costs associated with healthcare for their children. In addition, a child's poor health can impact caregivers’ health and quality of life. These "spill-over" impacts are often ignored in economic evaluations. Our goal is to develop and test a comprehensive tool that combines existing and newly developed surveys to capture all economic burdens on caregivers of children who receive hospital based care. METHODS:  Surveys to caregivers (n=70) of children (ages 0 to 18) were administered immediately after initial hospital care, at 6 weeks and 3 months follow-up. Surveys measure direct OOP health care costs (deductibles, co-insurance, co-pays and other non-reimbursable medical expenses), indirect costs associated with lost productivity (missed work days and lower productivity at work), travel, accommodation, formal, informal caregiver costs and other indirect costs. In addition, surveys measure quality of life among caregivers (EQ-5D-3L). All surveys have been validated previously or whenever validated surveys did not exist, questions were borrowed from large national surveys in the US. RESULTS:  Surveys took about 15 minutes to complete. Caregivers incured OOP costs in all categories above, although these costs were not very large relative to the cost of the major inpatient event. There was also evidence that caregiver have a slightly lower EQ-5D scores when compared to the general population (age and sex adjusted). CONCLUSIONS: Incorporating spill-over effects to caregivers of patients is important in order to better capture the impacts of a health condition and associated care on caregivers. These effects can be measured through a relatively easy to operationalize survey. Estimates of these impacts should be incorporated in economic evaluations of burden of disease and in cost-effectiveness analyses.