Do Costs in the Education Sector Matter? A Systematic Literature Review of the Economic Impact of Psychosocial Problems on the Education Sector

Irina Pokhilenko, Luca M. M. Janssen, Silvia M. A. A. Evers, Ruben M. W. A. Drost, Lena Schnitzler, Aggie T. G. Paulus

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Background: Psychosocial (e.g., anxiety or behavior) problems lead to costs not only in the healthcare sector but also in education and other sectors. As psychosocial problems develop during the critical period of establishing educational trajectories, education costs are particularly relevant in the context of psychosocial problems among children and adolescents. Objectives: This study aimed to gain insights into the methods used for the inclusion of education costs in health economics studies and into the proportion of the education costs in relation to the total costs associated with a condition or an intervention. Methods: We systematically searched the PubMed, Embase, SSCI, CINAHL, PsycINFO, ERIC, and Econlit databases in August 2019 for economic evaluations of mental health, psychosocial and educational interventions, and cost-of-illness studies of mental, behavioral, and neurodevelopmental disorders conducted from a societal perspective in populations of children and adolescents. An additional search was conducted in February 2021 to update the review. Results: In total, 49 articles were included in the analysis. The most common cost items were special education, school absenteeism, and various educational professionals (educational psychologist). A variety of methods were employed for the identification, measurement, and/or valuation of education costs. The proportion of education costs to the total costs of condition/intervention ranged from 0 to 67%, with the mean being 18.5%. Discussion: Since education costs can constitute a significant proportion of the total costs of an intervention or condition, including them in health economics studies might be important in informing optimal resource allocation decisions. Although various methods are available for including education costs in health economics studies, further research is needed to develop evidence-based methods for producing comparable estimates.

Original languageEnglish
Pages (from-to)889-900
Number of pages12
Issue number8
Early online date14 Jun 2021
Publication statusPublished - Aug 2021

Bibliographical note

Funding Information:
I. Pokhilenko and LMM Janssen are partially funded by the PECUNIA project, which has received funding from the European Union’s Horizon 2020 research and innovation program under Grant agreement no. 779292.

Publisher Copyright:
© 2021, The Author(s).

ASJC Scopus subject areas

  • Pharmacology
  • Health Policy
  • Public Health, Environmental and Occupational Health


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