Understanding the economic implications of Down syndrome: labour market and healthcare perspectives

Down syndrome presents significant economic challenges for families navigating complex healthcare systems. This study explores the economic burden and healthcare accessibility for Saudi families managing Down syndrome care, emphasizing urban-rural disparities within the dual public-private healthcare system. Using a cross-sectional survey of 220 families from Riyadh and Al-Jouf regions, multiple regression and service integration analyses were conducted. Results indicate that monthly care costs consume approximately one-third of average household income, with medical expenses and daily care hours showing the strongest associations with total care cost, while higher government support was associated with lower reported care costs. Significant urban-rural gaps emerged in therapy access and educational support. Insurance coverage and specialized service access were notably higher in urban areas, while transportation costs disproportionately burdened rural families. These findings indicate scope for strengthened government support, improved rural healthcare infrastructure, and insurance reform. On this basis, the study sets out targeted policy options and the potential value of a centralized database for monitoring healthcare costs, with a view to informing evidence-based strategies aligned with Vision 2030 healthcare transformation goals.