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

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
Journal of developmental and behavioral pediatrics: JDBP (Impact Factor: 2.13). 12/2011; 33(1):2-8. DOI: 10.1097/DBP.0b013e31823969de
Source: PubMed


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.

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    • "Comorbidity is common in individuals with ASD, and more than 70 % have concurrent conditions (Lai et al. 2014). Peacock et al. (2012) found that 47 % of children with ASD had at least one selected co-occurring condition, with attention deficit/hyperactivity disorder (ADHD) the most common, at 30 %. Children with ASD and intellectual disability (ID) incurred expenditures 2.7 times higher than did children with ASD and no co-occurring conditions. Lunsky et al. (2009) reported that inpatients with ASD and ID were recommended for a higher level of care than hospital service users without ID. "
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    ABSTRACT: This paper aims to examine health care utilization and expenditure in the provision of medical care to understand the medical care burden of children with autism spectrum disorders based on recent literature reviews. This article reviews the recent literature in Medline, PubMed, and Google by using key terms that are relevant to autism spectrum disorder (ASD) and health care (medical care) utilization, medical care costs, and expenditures. I also hand-searched the reference lists of all of the included articles and recent narrative and systematic reviews related to medical care utilization and the costs of ASD to identify potentially relevant articles. The literature on medical care utilization and expenditures related to ASD highlights the fact that the disorder imposes high medical care burdens on families and on society. It is necessary to initiate appropriate, comprehensive, and accessible medical care services for individuals with ASD, particularly for those with comorbid conditions. Future studies should examine the impact of such improvements in the management of children with ASD on medical care utilization and costs.
    06/2014; 1(3). DOI:10.1007/s40489-014-0023-8
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    • "Having a child with an ASD diagnosis can be financially taxing to families as well. A recent study on the average annual medical costs for Medicaid-enrolled children with ASDs found that these children accrued $10,709 in medical expenses per child, nearly six times higher than the average costs for children without ASDs ($1,812; Peacock et al. 2012). These figures corroborate the findings of Shimabukuro et al. (2008) who report that yearly medical expenditures for individuals with ASDs are four to six times greater than those for individuals without an ASD. "
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    ABSTRACT: Available research demonstrates that autism spectrum disorders (ASDs) affect couples in a variety of different ways. Some partners draw closer to one another through the experience of caring for a child on the autism spectrum while others experience relationship dissatisfaction, separation, and divorce. Yet other research reveals that many couples raising children with ASDs may experience an initial dip in relationship satisfaction but, after adjusting to a new way of life and developing new expectations for their children, are later able to bond in novel ways. Thus, a marriage-friendly approach to therapy, which focuses on helping partners remain committed to each other through the trials and tribulations of life, may allow these couples to work through the difficulties of raising children on the autism spectrum without resorting to separation or divorce. Ethical implications of a marriage-friendly approach to therapy with couples raising children with ASDs are also considered.
    Contemporary Family Therapy 12/2012; 34(4). DOI:10.1007/s10591-012-9213-7
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    • "Taken as a group, these studies provide considerable evidence that healthcare expenditures for children with ASD significantly exceed those for children with other disabilities and typically developing children (Croen et al. 2006; Liptak et al. 2006; Mandell et al. 2006; Leslie and Martin 2007; Shimabukuro et al. 2008). Few studies have explored the variation in service use and costs among children with ASD (Aman et al. 2003; Oswald and Sonenklar 2007a, b; Rosenberg et al. 2010; Wang and Leslie 2011; Logan et al. 2012; Lokhandwala et al. 2012; Peacock et al. 2012). In particular, their service use at various developmental stages has rarely been examined (Howlin et al. 2004). "
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    ABSTRACT: This study examined differences by age in service use and associated expenditures during 2005 for Medicaid-enrolled children with autism spectrum disorders. Aging was associated with significantly higher use and costs for restrictive, institution-based care and lower use and costs for community-based therapeutic services. Total expenditures increased by 5 % with each year of age; by 23 % between 3-5 and 6-11 year olds, 23 % between 6-11 and 12-16, and 14 % between 12-16 and 17-20 year olds. Use of and expenditures for long-term care, psychiatric medications, case management, medication management, day treatment/partial hospitalization, and respite services increased with age; use of and expenditures for occupational/physical therapy, speech therapy, mental health services, diagnostic/assessment services, and family therapy declined.
    Journal of Autism and Developmental Disorders 09/2012; 43(4). DOI:10.1007/s10803-012-1637-2 · 3.06 Impact Factor
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