De Ridder Annemieke, De Graeve Diana
Department of Economics and Mathematics, Faculty of Applied Economics, University of Antwerp, Antwerp, Belgium.
Clin Drug Investig. 2006;26(2):75-90. doi: 10.2165/00044011-200626020-00003.
The purpose of this study was to provide quantitative information on the economic, social and emotional burden borne by families of children with attention-deficit hyperactivity disorder (ADHD) and on the public healthcare costs of a child with ADHD in Flanders, Belgium, and to compare costs of ADHD children with those of siblings without the disorder.
A pilot-tested questionnaire was sent to all members of the Flemish ADHD society in February 2003. Parents were asked to record utilisation of healthcare, social care and other non-medical resources for their ADHD child and his/her sibling. In addition, data were collected on ADHD severity (IOWA-Conners Rating Scale) and on the sociodemographic and economic characteristics of the parents. Parents' out-of-pocket and public annual costs were calculated using tariffs. These costs were corrected for several confounding variables using general linear model (GLM) estimates.
ADHD affects school results and parents' productivity and places a psychological and emotional burden on the family. Childhood ADHD also results in a significantly higher use of healthcare: ADHD children have a significantly higher probability of visiting a general practitioner (60.3% vs 37.4%) and a specialist (50.9% vs 12.9%); they also visit the emergency department significantly more often (26% vs 12.1%), and they are hospitalised significantly more often (14% vs 8.4%). Consequently, Flemish children with ADHD incur significantly higher medical costs than their siblings without the disorder. Even after correction for several covariates, these cost differences are still striking. In fact, compared with their sibling, the annual cost for an ADHD child is more than six times higher for the parent (Euro 588.3 vs Euro 91.5), and public costs are twice as high (Euro 779 vs Euro 371.3) [year of costing 2002].
Childhood ADHD results in significantly higher use of healthcare and adversely affects academic achievements and parents' productivity.
本研究旨在提供有关注意力缺陷多动障碍（ADHD）患儿家庭所承担的经济、社会和情感负担以及比利时弗拉芒地区ADHD患儿公共医疗费用的定量信息，并将ADHD患儿的费用与无该疾病的兄弟姐妹的费用进行比较。
2003年2月，向弗拉芒ADHD协会的所有成员发送了一份经过预测试的问卷。要求家长记录其ADHD患儿及其兄弟姐妹对医疗保健、社会护理和其他非医疗资源的使用情况。此外，收集了有关ADHD严重程度（爱荷华-康纳斯评定量表）以及家长的社会人口统计学和经济特征的数据。使用收费标准计算家长的自付费用和年度公共费用。使用一般线性模型（GLM）估计对这些费用进行了几个混杂变量的校正。
ADHD会影响学业成绩和家长的生产力，并给家庭带来心理和情感负担。儿童期ADHD还导致医疗保健的使用显著增加：ADHD患儿看全科医生的概率显著更高（60.3%对37.4%），看专科医生的概率也显著更高（50.9%对12.9%）；他们去急诊室的次数也显著更多（26%对12.1%），住院的次数也显著更多（14%对8.4%）。因此，弗拉芒地区患有ADHD 的儿童产生的医疗费用明显高于其没有该疾病的兄弟姐妹。即使在对几个协变量进行校正之后，这些费用差异仍然很显著。事实上，与他们的兄弟姐妹相比，ADHD患儿的家长每年的费用高出六倍多（588.3欧元对91.5欧元），公共费用高出一倍（779欧元对371.3欧元）[成本计算年份为2002年]。
儿童期ADHD导致医疗保健的使用显著增加，并对学业成绩和家长的生产力产生不利影响。
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