Paternity leave in Sweden—Costs, savings and health gains

ObjectivesThe initial objective is to examine the relationship between paternity leave in 1978–1979 and male mortality during 1981–2001, and the second objective is to calculate the cost-effectiveness of the 1974 parental insurance reform in Sweden.MethodsBased on a population of all Swedish couples who had their first child together in 1978 (45,801 males), the risk of death for men who took paternity leave, compared with men who did not, was estimated by odds ratios. The cost-effectiveness analysis considered costs for information, administration and production losses, minus savings due to decreased sickness leave and inpatient care, compared to health gains in life-years and quality-adjusted life-years (QALYs).ResultsIt is demonstrated that fathers who took paternity leave have a statistically significant decreased death risk of 16%. Costs minus savings (discounted values) stretch from a net cost of EUR 19 million to a net saving of EUR 11 million, and the base case cost-effectiveness is EUR 8000 per QALY.ConclusionsThe study indicates that that the right to paternity leave is a desirable reform based on commonly stated public health, economic, and feminist goals. The critical issue in future research should be to examine impact from health-related selection.