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Leslie S. Wilson, PhD, Judith Tedlie Moskowitz, PhD, MPH, Michael Acree, PhD, Melvin B. Heyman, MD, MPH, Paul Harmatz, MD, Stephen J. Ferrando, MD and Susan Folkman, PhD

Leslie S. Wilson is with the Departments of Pharmacy and of Medicine, University of California, San Francisco. Judith Tedlie Moskowitz, Michael Acree, and Susan Folkman are with the Department of Medicine, University of California, San Francisco. Melvin B. Heyman is with the Department of Pediatrics, University of California, San Francisco. Paul Harmatz is with the Department of Pediatrics, Children’s Hospital and Research Center at Oakland, Oakland, Calif. Stephen J. Ferrando is with the Weill Medical College of Cornell University, Ithaca, NY.

Correspondence: Requests for reprints should be sent to Leslie Wilson, PhD, University of California, San Francisco, 3333 California, Box 0613, Suite 420M, San Francisco, CA 94143 (e-mail: lwilson{at}itsa.ucsf.edu).

Objectives. We compared types, amounts, and costs of home care for children with HIV and chronic illnesses, controlling for the basic care needs of healthy children to determine the economic burden of caring for and home care of chronically ill children.

Methods. Caregivers of 97 HIV-positive children, 101 children with a chronic illness, and 102 healthy children were surveyed regarding amounts of paid and unpaid care provided. Caregiving value was determined according to national hourly earnings and a market replacement method.

Results. Chronically ill children required significantly more care time than HIV-positive children (7.8 vs 3.9 hours per day). Paid care accounted for 8% to 16% of care time. Annual costs were $9300 per HIV-positive child and $25 900 per chronically ill child. Estimated national annual costs are $86.5 million for HIV-positive children and $155 to $279 billion for chronically ill children.

Conclusions. Informal caregiving represents a substantial economic value to society. The total care burden among chronically ill children is higher than that among children with HIV.

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