Economic burden of childhood autism spectrum disorders.
Economic burden of childhood autism spectrum disorders.
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DOI：
10.1542/peds.2013-0763
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发表时间：
2014-03
期刊：
影响因子：
8
通讯作者：
Prosser LA
中科院分区：
文献类型：
--
作者：
Lavelle TA;Weinstein MC;Newhouse JP;Munir K;Kuhlthau KA;Prosser LA
评估自闭症谱系障碍 (ASD) 诊断与服务使用、护理人员时间和成本结果之间的关联。我们使用来自与全国健康访谈调查相关的医疗支出小组调查和一项针对特定研究的调查的全国数据来估计 3 至 17 岁儿童（无论是否患有家长报告的 ASD）的医疗保健、学校、自闭症谱系障碍相关治疗、家庭协调服务以及看护时间的年度利用率和费用。回归分析估计了 ASD 诊断和费用之间的关联，并控制了儿童性别、年龄、种族/民族、保险状况、家庭收入、国家地区和城乡分类以及非 ASD 相关疾病。与没有 ASD 的儿童相比，家长报告的 ASD 儿童的医疗保健就诊次数和处方药使用率更高 (P < .05)。自闭症谱系障碍 (ASD) 组中的儿童使用特殊教育服务的比例较高（76% 对比对照组的 7%，P < .05）。在调整儿童人口统计特征和非 ASD 相关疾病后，ASD 与较高的医疗保健费用相关 3020 美元（95% 置信区间 [CI]：1017-4259 美元），以及 14 061 美元（95% CI：4390-24 302 美元）的非医疗保健总费用较高，其中包括 8610 美元（95% CI：6595-10 421 美元）的高等教育费用成本。在调整后的分析中，与对照父母相比，报告孩子患有自闭症谱系障碍的父母的自付费用并没有明显更高，也没有花更多的时间在看护活动上。与 ASD 相关的经济负担是巨大的，可以在我们社会的多个部门中衡量。先前针对医疗保健的分析低估了这种经济负担，特别是对学校系统而言。
To estimate the associations between autism spectrum disorder (ASD) diagnoses and service use, caregiver time, and cost outcomes. We used national data from the Medical Expenditure Panel Survey linked to the National Health Interview Survey and a study-specific survey to estimate the annual utilization and costs for health care, school, ASD-related therapy, family-coordinated services, as well as caregiver time in children aged 3 to 17 years, with and without parent-reported ASD. Regression analyses estimated the association between ASD diagnosis and cost, controlling for child gender, age, race/ethnicity, insurance status, household income, country region and urban/rural classification, and non–ASD-related illnesses. Children with parent-reported ASD had higher levels of health care office visits and prescription drug use compared with children without ASD (P < .05). A greater proportion of children in the ASD group used special educational services (76% vs 7% in the control group, P < .05). After adjusting for child demographic characteristics and non–ASD-associated illnesses, ASD was associated with $3020 (95% confidence interval [CI]: $1017–$4259) higher health care costs and $14 061 (95% CI: $4390–$24 302) higher aggregate non–health care costs, including $8610 (95% CI: $6595–$10 421) higher school costs. In adjusted analyses, parents who reported that their child had ASD did not have significantly higher out-of-pocket costs or spend more time on caregiving activities compared with control parents. The economic burden associated with ASD is substantial and can be measured across multiple sectors of our society. Previous analyses that focused on health care underestimated this economic burden, particularly for school systems.
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