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Peter Muennig, MD, MPH and Steven H. Woolf, MD, MPH

Peter Muennig is with the Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY. Steven H. Woolf is with the Departments of Family Medicine, Epidemiology, and Community Health, Virginia Commonwealth University, Richmond.

Correspondence: Requests for reprints should be sent to Peter Muennig, MD, MPH, Mailman School of Public Health, Department of Health Policy and Management, 600 W 168th St, New York, NY 10032 (e-mail: pm124{at}columbia.edu).

Objectives. We estimated the costs associated with reducing class sizes in kindergarten through grade 3 as well as the effects of small class sizes on selected outcomes such as quality-adjusted life-years and future earnings.

Methods. We used multiple data sets to predict changes in the outcomes assessed according to level of educational attainment. We then used a Markov model to estimate future costs and benefits incurred and quality-adjusted life-years gained per additional high school graduate produced over time.

Results. From a societal perspective (incorporating earnings and health outcomes), class-size reductions would generate a net cost savings of approximately $168 000 and a net gain of 1.7 quality-adjusted life-years for each high school graduate produced by small classes. When targeted to low-income students, the estimated savings would increase to $196 000 per additional graduate. From a governmental perspective (incorporating public expenditures and revenues), the results of reducing class sizes ranged from savings in costs to an additional cost of $15000 per quality-adjusted life-year gained.

Conclusions. Reducing class sizes may be more cost-effective than most public health and medical interventions.

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