Autism Spectrum Disorders and Health Care Expenditures: The Effects of Co-Occurring Conditions

• Published in: Journal of developmental and behavioral pediatrics Vol. 33; no. 1; pp. 2 - 8
• Main Authors: PEACOCK, Georgina, AMENDAH, Djesika, OUYANG, Lijing, GROSSE, Scott D
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 2012; Lippincott Williams & Wilkins Ovid Technologies
• Subjects: Adolescent; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - economics; Attention Deficit Disorder with Hyperactivity - epidemiology; Autism; Biological and medical sciences; Child; Child clinical studies; Child Development Disorders, Pervasive - complications; Child Development Disorders, Pervasive - economics; Child Development Disorders, Pervasive - epidemiology; Child, Preschool; Childrens health; Comorbidity; Developmental disorders; Epilepsy - complications; Epilepsy - economics; Epilepsy - epidemiology; Female; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Health care expenditures; Health Expenditures - classification; Humans; Infant; Infantile autism; Intellectual Disability - complications; Intellectual Disability - economics; Intellectual Disability - epidemiology; Male; Medicaid; Medicaid - economics; Medical sciences; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Pediatrics; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Registries; United States - epidemiology; United States; North America; America; United States > US; Health insurance; Nervous system diseases; cost; health care use; Epilepsy; Use; Developmental disorder; Health service; Cerebral disorder; Autism; Hyperkinesia; Pervasive developmental disorder; Convulsion; expenditures; Central nervous system disease; Expenditure; seizures; Id; Neurological disorder; Medicaid; autism spectrum disorder; Psychomotor disorder; Public health; hyperkinetic syndrome
• ISSN: 0196-206X; 1536-7312
• DOI: 10.1097/DBP.0b013e31823969de

Children with autism spectrum disorders (ASDs) often have co-occurring conditions, but little is known on the effect of those conditions on their medical care cost. Medical expenditures attributable to ASDs among Medicaid-enrolled children were calculated, and the effects of 3 commonly co-occurring conditions--intellectual disability (ID), attention deficit/hyperactivity disorder (ADHD), and epilepsy-on those expenditures were analyzed.
Using MarketScan Medicaid Multi-State Databases (2003-2005) and the International Classification of Disease, Ninth Revision, children with ASD were identified. Children without ASD formed the comparison group. The 3 co-occurring conditions were identified among both the ASD and the comparison groups. Annual mean, median, and 95th percentile of total expenditures were calculated for children with ASD and the co-occurring conditions and compared with those of children without ASD. Multivariate analyses established the influence of each of those co-occurring conditions on the average expenditures for children with and without ASD.
In 2005, 47% of children with ASD had at least 1 selected co-occurring condition; attention deficit/hyperactivity disorder was the most common, at 30%. The mean medical expenditures for children with ASD were 6 times higher than those of the comparison group. Children with ASD and ID incurred expenditures 2.7 times higher than did children with ASD and no co-occurring condition.
Medicaid-enrolled children with ASD incurred higher medical costs than did Medicaid-enrolled children without ASD. Among Medicaid-enrolled children with ASD, cost varied substantially based on the presence of another neurodevelopmental disorder. In particular, children with ID had much higher costs than did other children with ASD.