Health Care Use and Costs for Children With Attention-Deficit/Hyperactivity Disorder

Chan, Eugenia; Zhan, Chunliu; Homer, Charles J.

doi:10.1001/archpedi.156.5.504

Cited by 167 publications

(110 citation statements)

References 26 publications

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“…4 Results of multiple cost studies consistently indicated that children with ADHD had higher annual medical costs than children without ADHD. [5][6][7][8][9][10][11] Treatment options for ADHD include medication management, behavioral treatment, or combination of the two, with medication management being the most cost-effective. 12 Stimulants are an effective first-line treatment option for the majority of ADHD patients, with about 70% of patients responding to treatment in the short term (within 6-10 weeks).…”

Section: Sample Selectionmentioning

confidence: 99%

Comparative Treatment Patterns, Resource Utilization, and Costs in Stimulant-Treated Children with ADHD Who Require Subsequent Pharmacotherapy with Atypical Antipsychotics Versus Non-Antipsychotics

Sikirica¹,

Pliszka²,

Betts³

et al. 2012

JMCP

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Section: Sample Selectionmentioning

confidence: 99%

Comparative Treatment Patterns, Resource Utilization, and Costs in Stimulant-Treated Children with ADHD Who Require Subsequent Pharmacotherapy with Atypical Antipsychotics Versus Non-Antipsychotics

Sikirica¹,

Pliszka²,

Betts³

et al. 2012

JMCP

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“…9,11 All children ,18 years old were followed for 2 years. Between 12 810 and 14 828 households were sampled annually from the US civilian, noninstitutionalized population drawn from the previous year' s National Health Interview Survey (NHIS).…”

Section: Study Design and Data Sourcementioning

confidence: 99%

“…Total health care expenditures included direct payments to health care providers for outpatient visits, home health care, prescriptions, dental visits, hospital stays, ED visits, and other medical equipment and expenses. 11,14 We separately considered out-of-pocket (copayments and payments not reimbursed by insurance), 17 office-based, inpatient, ED, and prescription costs. To avoid bias from extreme outliers and violations of the assumptions of normality of our statistical models, 9 we calculated all expenditure results with the top 2.5% of values trimmed to the 97.5 percentile.…”

Section: Outcome Measuresmentioning

confidence: 99%

“…9 Although they represent approximately 15% of the population, CSHCN account for 33.6% or more of total health care costs attributable to children. [9][10][11] CSHCN also have 4 times the number of hospitalizations, twice as many physician visits, 1.5 times as many emergency department (ED) visits, and receive 5 times the number of prescriptions. 9 Reflecting the impact of higher health care utilization and costs, approximately 40% of families of CSHCN experience burdensome out-ofpocket expenses even when they are eligible for safety net programs.…”

mentioning

confidence: 99%

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Shared Decision-Making and Health Care Expenditures Among Children With Special Health Care Needs

2011

PEDIATRICS

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WHAT'S KNOWN ON THIS SUBJECT: Children with special health care needs (CSHCN) account for more than one-third of pediatric health care costs. Little is known regarding the impact of shared decision-making (SDM) over time on child health care expenditures and utilization. WHAT THIS STUDY ADDS:In a national sample, we found that increasing SDM was associated with decreased health care costs and utilization for CSHCN. Results support prospective studies to determine if pediatric interventions to foster SDM reduce the financial burden of caring for CSHCN. abstract BACKGROUND AND OBJECTIVES: To understand the association between shared decision-making (SDM) and health care expenditures and use among children with special health care needs (CSHCN). METHODS:We identified CSHCN ,18 years in the 2002-2006 Medical Expenditure Panel Survey by using the CSHCN Screener. Outcomes included health care expenditures (total, out-of-pocket, office-based, inpatient, emergency department [ED], and prescription) and utilization (hospitalization, ED and office visit, and prescription rates). The main exposure was the pattern of SDM over the 2 study years (increasing, decreasing, or unchanged high or low). We assessed the impact of these patterns on the change in expenditures and utilization over the 2 study years.RESULTS: Among 2858 subjects representing 12 million CSHCN, 15.9% had increasing, 15.2% decreasing, 51.9% unchanged high, and 17.0% unchanged low SDM. At baseline, mean per child total expenditures were $2131. Over the 2 study years, increasing SDM was associated with a decrease of $339 (95% confidence interval: $21, $660) in total health care costs. Rates of hospitalization and ED visits declined by 4.0 (0.1, 7.9) and 11.3 (4.3, 18.3) per 100 CSHCN, and office visits by 1.2 (0.3, 2.0) per child with increasing SDM. Relative to decreasing SDM, increasing SDM was associated with significantly lower total and out-of-pocket costs, and fewer office visits. CONCLUSIONS:We found that increasing SDM was associated with decreased utilization and expenditures for CSHCN. Prospective study is warranted to confirm if fostering SDM reduces the costs of caring for CSHCN for the health system and families.

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“…An ADHD patient can cost the State approximately US$ 4,181/year due to special academic needs, 7 US$ 7,424 to 36,076/year due to criminal activities, 9 and about US$ 1,151/year due to health care utilization. 12 Recently, the incremental cost of ADHD in all age groups was estimated to range from US$ 143 to 266 billion/year in the United States alone. The educational and health care fractions of this cost for children ranged from US$ 15 to 25 billion/year and from US$ 21 to 44 billion/year, respectively.…”

Section: Introductionmentioning

confidence: 99%

Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

Maia

Stella²,

Wagner

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To perform a cost-utility analysis on the treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate immediate-release (MPH-IR) in children and adolescents from Brazil. Method: A Markov model was constructed to compare MPH-IR vs. no treatment. A 24-week naturalistic study was conducted to collect transition probabilities and utility data. Effectiveness was expressed as quality-adjusted life-years (QALY), and costs reported in 2014 international dollars (I$). The perspective was the Brazilian Unified Health System as payer, and the time horizon was 6 years. Results: Of 171 patients, 73 provided information at baseline, and 56 at week 24. Considering the MPH-IR monthly cost of I$ 38, the incremental cost-effectiveness ratio (ICER) of treatment was I$ 9,103/QALY for children and I$ 11,883/QALY for adolescents. In two-way sensitivity analysis, considering one Gross National Product per capita (I$ 11,530) as willingness-to-pay, a cost of no-treatment lower than I$ 45/month would render MPH-IR a cost-saving strategy. Discussion: MPH-IR treatment of children and adolescents is cost-effective for ADHD patients from the Brazilian public health system perspective. Both patients and the healthcare system might benefit from such a strategy. Trial registration number: NCT01705613.

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Health Care Use and Costs for Children With Attention-Deficit/Hyperactivity Disorder

Cited by 167 publications

References 26 publications

Comparative Treatment Patterns, Resource Utilization, and Costs in Stimulant-Treated Children with ADHD Who Require Subsequent Pharmacotherapy with Atypical Antipsychotics Versus Non-Antipsychotics

Comparative Treatment Patterns, Resource Utilization, and Costs in Stimulant-Treated Children with ADHD Who Require Subsequent Pharmacotherapy with Atypical Antipsychotics Versus Non-Antipsychotics

Shared Decision-Making and Health Care Expenditures Among Children With Special Health Care Needs

Cost-utility analysis of methylphenidate treatment for children and adolescents with ADHD in Brazil

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