Impact of non-medical out-of-pocket expenses on families of children with cerebral palsy following orthopaedic surgery.

Document Type


Publication Date




Journal Title

Journal of pediatric nursing.

MeSH Headings

Adolescent, Cerebral Palsy, Child, Child, Preschool, Cohort Studies, Disabled Children, Female, Financing, Personal, Health Expenditures, Hospitalization, Humans, Length of Stay, Male, Orthopedic Procedures, Prospective Studies, United States, Young Adult


PURPOSE: Limited research has been conducted on the non-medical out-of-pocket expenses (NOOPEs) incurred by families of children with chronic health conditions. The study objectives were to: 1) calculate the estimated NOOPEs incurred by families during hospitalization of their child, 2) identify predictors of high NOOPEs, and 3) assess the impact of the child's chronic health condition on the family's finances.

DESIGN AND METHODS: Prospective observational study. Parents were included if their child was 3-20years old, had severe, non-ambulatory cerebral palsy (CP), and scheduled for hip or spine surgery. Parents reported all NOOPEs incurred during their child's hospitalization using the Family Expense Diary. Families completed the subscales of the Impact on Family Scale and the Assessment of Caregivers Experience with Neuromuscular Disease. Descriptive and univariate and multiple hierarchical regression models were used in the analysis.

RESULTS: Fifty two parents participated. The total NOOPEs ranged from $193.00 to $7192.71 (M=$2001.92) per hospitalization representing an average of 4% of the family's annual earned income. Caregiver age (F=8.393, p

CONCLUSIONS AND PRACTICE IMPLICATIONS: Hospitalization is associated with numerous NOOPEs that create additional financial demands for families caring for a child with severe CP. NOOPEs should be addressed when preparing families for their children's planned hospital admissions, especially those families of CSHCN who experience significant financial impacts secondary to their children's care.



First Page


Last Page