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Health Care Use and Costs for Children With Attention-Deficit/Hyperactivity Disorder
National Estimates From the Medical Expenditure Panel Survey
Eugenia Chan, MD, MPH;
Chunliu Zhan, MD, PhD;
Charles J. Homer, MD, MPH
Arch Pediatr Adolesc Med. 2002;156:504-511.
Context Although attention-deficit/hyperactivity disorder (ADHD) is a highly
prevalent chronic condition of childhood, little is known about patterns of
health care use and associated expenditures.
Objective To compare health care use and costs among children with ADHD, children
with asthma, and the general pediatric population.
Design and Setting The 1996 Medical Expenditure Panel Survey, a nationally representative
household survey.
Participants All 5439 children aged 5 to 20 years from the 1996 Medical Expenditure
Panel Survey were included in this analysis. Children who had ADHD, asthma,
or neither (general population) were identified from International
Classification of Diseases, Ninth Revision, Clinical Modification codes
and prescription records.
Main Outcome Measures Mean health care use (outpatient visits, emergency department visits,
hospital stays, home health visit days, and prescriptions) and associated
expenditures.
Results We identified 165 children with ADHD, 322 with asthma, and 4952 with
neither diagnosis. Children with ADHD had significantly higher mean total
health care costs ($1151) compared with children with asthma ($1091; P<.05) and the general population ($712; P<.001). After adjusting for age, sex, race, household income, access
to care, parent education, and marital status, excess total costs were $479
for children with ADHD (P<.001) and $437 for children
with asthma (P<.01).
Conclusions Overall costs of care for children with ADHD are comparable to costs
for children with asthma and significantly greater than for the general pediatric
population. Specific types of health care use and the sources of expenditures
differ between children with ADHD and children with asthma. Because much ADHD-related
care occurs within school and mental health settings, these figures likely
underestimate the true costs of caring for children with this condition.
From the Division of General Pediatrics, Children's Hospital Boston,
Boston, Mass (Drs Chan and Homer); and the Agency for Healthcare Research
and Quality, Rockville, Md (Dr Zhan).
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