We conduct the first systematized review of the literature on the direct costs associated with living with a disability.
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We find 20 such studies, predominantly quantitative and for high-income countries.
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Costs are found to be sizeable and to vary according to the severity of disability, life cycle and household composition.
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Further research is recommended using a variety of approaches, and in the context of low- and middle-income countries.
Abstract
Background
There has been a growing interest in disability and poverty on the international research and policy stages. Poverty assessments for persons with disabilities may be affected by the experience of extra costs associated with a disability.
Objective
This article provides a systematized review of the global literature on the direct costs associated with living with a disability at the individual or household level.
Methods
We searched three databases for peer-reviewed journal articles that estimated extra costs associated with disability: Econlit, SocIndex and PubMed.
Results
We found 20 such studies conducted in 10 countries. These studies were predominantly from high-income countries. Although studies were heterogeneous (e.g., in terms of disability measures and cost methodologies), estimated costs were sizeable and some patterns were consistent across studies. Costs varied according to the severity of disability, life cycle and household composition. Highest costs were observed among persons with severe disabilities, and among persons with disabilities living alone or in small sized households.
Conclusions
More quantitative evidence is needed using rigorous methods, for instance evidence based on longitudinal data and as part of policy evaluations. More internationally comparable data on disability is required for the quantitative evidence to develop, especially in low- and middle-income countries where studies are scarce. Qualitative and participatory research is also needed, especially to investigate unmet needs, and the consequences of extra costs.