Health‐Related Performance Decrements Resulted in Substantial Financial Loss for Team USA Athletes at the Paris 2024 Olympic Games

Purpose: To estimate the financial impact of injury and illness among Team USA athletes who participated in the Paris 2024 Olympic Games and evaluate the cost-effectiveness of a feasible illness prevention program. Methods: All Team USA athlete-events at the Paris 2024 Olympic Games were analyzed. Precompetition betting markets were used to derive the expected performance. Counterfactual finish distributions were generated using a Markov ranking model. Injury- and illness-associated performance decrements were estimated relative to expected medal placement outcomes and translated into expected financial losses across 3 domains: Operation Gold performance incentives, athlete stipends, and estimated commercial value. Losses were summarized at the athlete-event, athlete, and Team USA levels. A cohort Markov cost-effectiveness model evaluated a potential illness prevention program using probabilistic sensitivity analysis. Results: = $10,000), including $462,409 attributable to injuries and $551,802 attributable to illnesses. Median athlete-event-level financial loss was $3000 (75th percentile: $5094; 90th percentile: $7758), whereas median athlete-level loss was $4710 (90th percentile: $15,617; maximum: $62,915), indicating substantial right skewness and concentration of losses. Illness events were associated with higher mean financial losses per event than injuries ($5109 vs $2486). An illness prevention program costing $200 per athlete and reducing illness risk by 40% was cost-saving, averting $220,721 in expected losses at a total cost of $117,000, yielding net savings of $103,721, and remaining cost-saving in 95.2% of probabilistic simulations. Conclusions: Injury and illness at the Olympic Games are associated with substantial and highly concentrated financial losses, with illnesses accounting for a disproportionate share of the total impact on Team USA athletes. Level of Evidence: Level IV, retrospective cohort study with counterfactual performance modeling.