Pelham William E, Foster E Michael, Robb Jessica A
Department of Psychology, Center for Children and Families, State University of New York at Buffalo, 318 Diefendorf Hall, 3435 Main Street, Building 20, Buffalo, NY 14214, USA.
J Pediatr Psychol. 2007 Jul;32(6):711-27. doi: 10.1093/jpepsy/jsm022. Epub 2007 Jun 7.
Using a cost of illness (COI) framework, this article examines the economic impact of attention-deficit/hyperactivity disorder (ADHD) in childhood and adolescence. Our review of published literature identified 13 studies, most conducted on existing databases by using diagnostic and medical procedure codes and focused on health care costs. Two were longitudinal studies of identified children with ADHD followed into adolescence. Costs were examined for ADHD treatment-related and other health care costs (all but 1 study addressed some aspect of health care), education (special education, 2 studies; disciplinary costs: 1 study), parental work loss (2 studies), and juvenile justice (2 studies). Based on this small and as yet incomplete evidence base, we estimated annual COI of ADHD in children and adolescents at $14,576 per individual (2005 dollars). Given the variability of estimates across studies on which that number is based, a reasonable range is between $12,005 and $17,458 per individual. Using a prevalence rate of 5%, a conservative estimate of the annual societal COI for ADHD in childhood and adolescence is $42.5 billion, with a range between $36 billion and $52.4 billion. Estimates are preliminary because the literature is incomplete; many potential costs have not been assessed in extant studies. Limitations of the review and suggestions for future research on COI of ADHD are provided.
本文采用疾病成本（COI）框架，研究了儿童和青少年注意力缺陷多动障碍（ADHD）的经济影响。我们对已发表文献的综述确定了13项研究，其中大多数是利用诊断和医疗程序代码在现有数据库上进行的，且重点关注医疗保健成本。两项是对已确诊患有ADHD的儿童进行跟踪至青春期的纵向研究。研究考察了ADHD治疗相关成本和其他医疗保健成本（除1项研究外，所有研究都涉及医疗保健的某些方面）、教育成本（特殊教育，2项研究；纪律处分成本：1项研究）、父母工作损失成本（2项研究）以及青少年司法成本（2项研究）。基于这一规模较小且尚不完整的证据基础，我们估计儿童和青少年ADHD的年度疾病成本为每人14,576美元（2005年美元）。鉴于该数字所依据的各项研究估计值存在差异，合理范围为每人12,005美元至17,458美元。按照5%的患病率计算，儿童和青少年ADHD的年度社会疾病成本保守估计为425亿美元，范围在360亿美元至524亿美元之间。这些估计是初步的，因为文献并不完整；现有研究尚未评估许多潜在成本。本文还提供了综述的局限性以及对ADHD疾病成本未来研究的建议。
