Chan Eugenia, Zhan Chunliu, Homer Charles J
Health Services Research, Children's Hospital Boston, 300 Longwood Ave, LO-240, Boston, MA 02115, USA.
Arch Pediatr Adolesc Med. 2002 May;156(5):504-11. doi: 10.1001/archpedi.156.5.504.
Although attention-deficit/hyperactivity disorder (ADHD) is a highly prevalent chronic condition of childhood, little is known about patterns of health care use and associated expenditures.
To compare health care use and costs among children with ADHD, children with asthma, and the general pediatric population.
The 1996 Medical Expenditure Panel Survey, a nationally representative household survey.
All 5439 children aged 5 to 20 years from the 1996 Medical Expenditure Panel Survey were included in this analysis. Children who had ADHD, asthma, or neither (general population) were identified from International Classification of Diseases, Ninth Revision, Clinical Modification codes and prescription records.
Mean health care use (outpatient visits, emergency department visits, hospital stays, home health visit days, and prescriptions) and associated expenditures.
We identified 165 children with ADHD, 322 with asthma, and 4952 with neither diagnosis. Children with ADHD had significantly higher mean total health care costs ($1151) compared with children with asthma ($1091; P<.05) and the general population ($712; P<.001). After adjusting for age, sex, race, household income, access to care, parent education, and marital status, excess total costs were $479 for children with ADHD (P<.001) and $437 for children with asthma (P<.01).
Overall costs of care for children with ADHD are comparable to costs for children with asthma and significantly greater than for the general pediatric population. Specific types of health care use and the sources of expenditures differ between children with ADHD and children with asthma. Because much ADHD-related care occurs within school and mental health settings, these figures likely underestimate the true costs of caring for children with this condition.
尽管注意力缺陷多动障碍（ADHD）是一种在儿童中高度流行的慢性疾病，但对于其医疗保健使用模式及相关支出却知之甚少。
比较患有ADHD的儿童、患有哮喘的儿童以及普通儿科人群的医疗保健使用情况和费用。
1996年医疗支出小组调查，一项具有全国代表性的家庭调查。
1996年医疗支出小组调查中所有5439名5至20岁的儿童都纳入了本分析。通过国际疾病分类第九版临床修订本编码和处方记录确定患有ADHD、哮喘或两者皆无（普通人群）的儿童。
平均医疗保健使用情况（门诊就诊、急诊就诊、住院、家庭健康访视天数和处方）及相关支出。
我们确定了165名患有ADHD的儿童、322名患有哮喘的儿童以及4952名未患这两种疾病的儿童。患有ADHD的儿童平均总医疗费用（1151美元）显著高于患有哮喘的儿童（1091美元；P<0.05）和普通人群（712美元；P<0.001）。在调整年龄、性别、种族、家庭收入、就医机会、父母教育程度和婚姻状况后，患有ADHD的儿童额外总费用为479美元（P<0.001），患有哮喘的儿童为437美元（P<0.01）。
ADHD患儿的总体护理费用与哮喘患儿相当，且显著高于普通儿科人群。ADHD患儿和哮喘患儿在特定类型的医疗保健使用和支出来源方面存在差异。由于许多与ADHD相关的护理发生在学校和心理健康机构，这些数字可能低估了护理患有这种疾病儿童的真实成本。
