Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA.
Psychiatr Serv. 2012 Oct;63(10):1019-25. doi: 10.1176/appi.ps.201100516.
Recent evidence suggests that children are increasingly diagnosed as having bipolar disorder, yet no studies have quantified treatment costs for pediatric patients. The objectives of the study were to identify one-year health services utilization and treatment costs among youths newly diagnosed as having bipolar disorder.
MarketScan administrative claims from 2005 to 2007 were used to construct a retrospective person-level cohort of children ages zero to 17 to identify one-year health services utilization and costs among privately insured youths with a bipolar diagnosis. Inpatient and outpatient services were categorized as mental health related or non–mental health related. Pharmacy costs were classified as psychotropic or nonpsychotropic.
In the sample (4,973 youths), one-year mean reimbursements for health services were $10,372, and patient out-of-pocket spending was $1,429 per child. Mental health services accounted for 71% of all health care spending, with psychotropic medications and inpatient care contributing the largest proportions of total spending (24% and 27%, respectively) .
The costs of care among privately insured children with bipolar disorder are similar to those of adults. However, spending on children is concentrated on mental health–related services. Because private insurance plans have historically limited mental health service benefits, the concentration of spending on mental health services may place a greater burden on families for out-of-pocket payments. As mental health parity is adopted by private insurers, monitoring its impact on patient utilization and costs of health services will be important, particularly for children with serious mental illness.
最近的证据表明，儿童被诊断为双相情感障碍的情况越来越多，但尚无研究量化儿科患者的治疗成本。本研究的目的是确定新诊断为双相情感障碍的青少年一年内的卫生服务利用情况和治疗费用。
利用 2005 年至 2007 年 MarketScan 行政索赔数据，构建了一个回顾性个人水平队列，纳入年龄在 0 至 17 岁的儿童，以确定有双相诊断的私人保险青少年一年内的卫生服务利用情况和费用。住院和门诊服务分为与心理健康相关或非心理健康相关。药房费用分为精神药物和非精神药物。
在样本（4973 名青少年）中，一年内健康服务的平均报销金额为 10372 美元，每名儿童自付费用为 1429 美元。心理健康服务占所有医疗保健支出的 71%，精神药物和住院治疗分别占总支出的最大比例（分别为 24%和 27%）。
有私人保险的双相情感障碍儿童的护理费用与成人相似。然而，儿童的支出集中在与心理健康相关的服务上。由于私人保险计划历来限制心理健康服务福利，因此支出集中在心理健康服务上可能会给家庭带来更大的自付费用负担。随着私人保险公司采用精神健康平等，监测其对患者利用和医疗服务成本的影响将非常重要，特别是对患有严重精神疾病的儿童而言。
