Children and Adolescents With Attention Deficit-Hyperactivity Disorder: 1. Prevalence and Cost of Care

Abstract

The objective of this study was to use population-based data to estimate the prevalence and cost of treatment for attention-deficit hyperactivity disorder (ADHD). The North Dakota Department of Health Claims Database was used to estimate the administrative prevalence, annual cost of care per case, and total annual cost of care for subjects with ADHD compared with controls. The case population was 7745, and the mean prevalence rate was 3.9%, with a peak prevalence at 10 years of age. For children with ADHD, the annual cost of care was $649 compared with that of controls at $495. Cost of care attributable to ADHD was $649 - $495 = $154 (31%). Utilization by children with ADHD with publicly funded payers was increased 25 to 175% over that of children with privately funded coverage. In North Dakota, the annual cost of care for children with ADHD was $5.1 million, 5.6% of all health care costs for children. The annual attributable cost of care was $1.79 million. Thus, 1.9% of total health expenditures for children was attributable to ADHD. In the United States, the cost of care attributable to children with ADHD would be $2.15 billion annually. (J Child Neurol 2003;18:555—561).

Get full access to this article

View all access options for this article.

References

American Psychiatric Association : Diagnostic and Statistical Manual of Mental Disorders DSM-IV, 4th ed. Washington, DC: American Psychiatric Association, 1994.

Zametkin AJ , Ernst M. : Problems in the management of attention-deficit-hyperactivity disorder. N Engl J Med 1999;340:40—46.

Hill JC , Schoener EP : Age-dependent decline of attention deficit hyperactivity disorder. Am J Psychiatry 1996;153:1143—1146.

Biederman J. , Faraone S. , Milberger S. , et al: Predictors of persistence and remission of ADHD into adolescence: Results from a four-year prospective follow-up study . J Am Acad Child Adolesc Psychiatry 1996;35:343—351.

Szatmari P. , Offord DR , Boyle MH : Correlates, associated impairments and patterns of service utilization of children with attention deficit disorder: Findings from the Ontario Child Health Study. J Child Psychol Psychiatry 1989 ;30:205—217.

Berry CA , Shaywitz SE , Shaywitz BA : Girls with attention deficit disorder: A silent minority? A report on behavioral and cognitive characteristics. Pediatrics 1985;76:801—809.

Leibson CL , Katusic SK , Barbaresi WJ , et al: Use and costs of medical care for children and adolescents with and without attention-deficit/hyperactivity disorder. JAMA 2001;285:60—66.

Guevara J. , Lozano P. , Wickizer T. , et al: Utilization and cost of health care services for children with attention-deficit/hyperactivity disorder. Pediatrics 2001;108:71—78.

Taylor E. , Sandberg S. , Thorley G. , Gilles S. : Hyperkinetic disorder: Prevalence, definition, and associations. [Maudsley Monographs 33], 93—113. 1991. Oxford, England, Oxford University Press. The epidemiology of childhood hyperactivity.

10.

Szatmari P. , Offord DR , Boyle MH : Ontario Child Health Study: Prevalence of attention deficit disorder with hyperactivity. J Child Psychol Psychiatry 1989;30:219—230.

11.

Chan E. , Zhan C. , Homer CJ : Health care use and costs for children with attention-deficit/hyperactivity disorder: National estimates from the medical expenditure panel survey. Arch Pediatr Adolesc Med 2002; 156:504-511.

12.

Practice Management Information Corporation : ICD-9-CM International Classification of Diseases, 9th rev, Clinical Modification, 5th ed, color coded, 1997, Hospital ed. Los Angeles, CA, PMIC, Practice Management Information Corp.