Societal costs and quality of life of children suffering from attention deficient hyperactivity disorder (ADHD)
Societal costs and quality of life of children suffering from attention deficient hyperactivity disorder (ADHD)
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DOI：
10.1007/s00787-007-0603-6
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发表时间：
2007-08-01
影响因子：
6.4
通讯作者：
Buitelaar, J. K.
中科院分区：
文献类型：
--
作者：
Hakkaart-van Roijen, L.;Zwirs, B. W. C.;Buitelaar, J. K.
背景：在荷兰，注意缺陷多动障碍（ADHD）对这些儿童及其父母的医疗保健利用、成本和生活质量的影响尚不清楚。目的评估ADHD患者的直接医疗费用及其生活质量，以及其母亲的直接医疗费用。研究设计我们选择了一组70名儿童，这些儿童根据ADHD的DSM-IV诊断标准接受儿科医生的治疗。为了比较起见，我们还纳入了一个非匹配组，其中有35名有行为问题的儿童和60名没有行为问题的儿童，这些儿童来自一项基于大型学校人群的ADHD检测研究。我们使用Trimbos和iMTA“精神疾病相关费用问卷”（TiC-P）收集了儿童医疗保健利用情况的信息。使用荷兰儿童健康问卷（CHQ PF50）的50项父母版收集他们的健康相关生活质量。分别在基线和6个月时进行测量。随后，我们收集了关于母亲的保健利用以及由于缺勤和效率降低而造成的生产损失的数据。结果每位ADHD患者每年的平均直接医疗费用为（原文如此）2040或（原文如此）1173（不包括一名长期住院的患者），而有行为问题的儿童组为288，无行为问题的儿童组为177。与单独患有ADHD的儿童相比，患有精神疾病的儿童的直接医疗费用明显更高。ADHD患者的母亲每年的平均医疗费用显著高于有行为问题儿童的母亲和无行为问题儿童的母亲，分别为（sic）728、（sic）202和（sic）154。两组间的身体综合评分无显著差异。然而，与其他两个样本的儿童相比，ADHD患者在心理社会综合得分维度上的得分明显较低。ADHD患者的母亲因缺勤和工作效率降低而造成的平均年间接成本为243美元，而有行为问题儿童的母亲为408美元，无行为问题儿童的母亲为674美元。结论ADHD患者的直接医疗费用较高。此外，我们的研究表明，ADHD患者的母亲似乎伴随着更高的（精神）卫生保健费用，以及这一群体的间接费用增加。
Background The impact of attention deficit hyperactive disorder (ADHD) in the Netherlands on health care utilisation, costs and quality of life of these children, as well as of their parents is unknown. Objective The aim of this study was to assess the direct medical costs of patients suffering from ADHD and their quality of life as well as the direct medical costs of their mothers. Study design We selected a group of 70 children who were being treated by a paediatrician for ADHD based on the DSM-IV diagnostic criteria for ADHD. For comparison's sake, we also included a non-matched group of 35 children with behaviour problems and 60 children with no behaviour problem from a large school population-based study on the detection of ADHD. We collected information on the health care utilisation of the children applying the Trimbos and iMTA questionnaire on Costs associated with Psychiatric illness' (TiC-P). Their health related quality of life was collected by using the Dutch 50-item parent version of the Child Health Questionnaire (CHQ PF50). Measurements were at baseline and at 6 months. Subsequently, we collected data on the health utilisation of the mothers and their production losses due to absence from work and reduced efficiency. Results The mean direct medical costs per ADHD patient per year were (sic)2040 or (sic)1173 when leaving out one patient with a long-term hospital admission, compared to (sic)288 for the group of children with behaviour problems and (sic)177 for the group of children with no behaviour problems. The direct medical costs for children who had psychiatric co-morbidities were significantly higher compared to children with ADHD alone. The mean medical costs per year for the mothers of the ADHD patients were significantly higher than for the mothers of the children with behaviour problems and the mothers of children with no behaviour problems respectively (sic)728, (sic)202 and (sic)154. The physical summary score showed no significant differences between the groups. However, the score on the Psychosocial Summary Score dimension was significantly lower for ADHD patients compared to the scores of the children in the two other samples. The mean annual indirect costs due to absence from work and reduced efficiency at work were (sic)243 for the mothers of the ADHD patients compared to (sic)408 for the mothers of children with behaviour problems and (sic)674 for the mothers of children with no behaviour problems. Conclusion Our study showed that the direct medical costs of ADHD patients were relatively high. Additionally, our study indicated that ADHD appears to be accompanied by higher (mental) health care costs for the mothers of ADHD patients and by increased indirect costs for this group.