Primary Care and Public Health, School of Medicine, The Pharma Research Centre, Cardiff Medicentre, Cardiff University, Cardiff CF14 4UJ, UK.
Child Adolesc Psychiatry Ment Health. 2013 Oct 11;7(1):34. doi: 10.1186/1753-2000-7-34.
Attention deficit/hyperactivity disorder (ADHD) is a common disorder that often presents in childhood and is associated with increased healthcare resource use. The aims of this study were to characterise the epidemiology of diagnosed ADHD in the UK and determine the resource use and financial costs of care.
For this retrospective, observational cohort study, patients newly diagnosed with ADHD between 1998 and 2010 were identified from the UK Clinical Practice Research Datalink (CPRD) and matched to a randomly drawn control group without a diagnosis of ADHD. The prevalence and incidence of diagnosed ADHD were calculated. Resource utilisation and corresponding financial costs post-diagnosis were estimated for general practice contacts, investigations, prescriptions, outpatient appointments, and inpatient admissions.
Incidence of diagnosed ADHD (and percentage change using 1998 as a reference) increased from 6.9 per 100,000 population in 1998 to 12.2 per 100,000 (78%) in 2007 and then fell to 9.9 per 100,000 (44%) by 2009. The corresponding prevalence figures were 30.5, 88.9 (192%) and 81.5 (167%) per 100,000. Incidence and prevalence were higher in males than females. Mean annual total healthcare costs were higher for ADHD cases than controls (£1,327 versus £328 for year 1, £1,196 vs. £337 for year 2, £1,148 vs. £316 for year 3, £1,126 vs. £325 for year 4, and £1,112 vs. £361 for year 5).
The prevalence of diagnosed ADHD in routine practice in the UK was notably lower than in previous reports, and both prevalence and incidence of diagnosed ADHD in primary care have fallen since 2007. Financial costs were more than four times higher in those with ADHD than in those without ADHD.
注意力缺陷/多动障碍(ADHD)是一种常见疾病,通常在儿童时期发病,并与增加的医疗资源使用相关。本研究的目的是描述英国诊断性 ADHD 的流行病学特征,并确定护理的资源使用情况和经济成本。
本回顾性、观察性队列研究从英国临床实践研究数据链(CPRD)中确定了 1998 年至 2010 年间新诊断为 ADHD 的患者,并与未诊断为 ADHD 的随机抽取的对照组患者相匹配。计算了诊断性 ADHD 的患病率和发病率。估计了确诊后全科医生就诊、检查、处方、门诊预约和住院治疗的资源使用情况和相应的经济成本。
诊断性 ADHD 的发病率(以 1998 年为参考的百分比变化)从 1998 年的每 10 万人 6.9 例上升到 2007 年的每 10 万人 12.2 例(78%),然后在 2009 年下降到每 10 万人 9.9 例(44%)。相应的患病率分别为每 10 万人 30.5、88.9(192%)和 81.5(167%)。男性的发病率和患病率均高于女性。ADHD 病例的年均总医疗保健费用高于对照组(第 1 年为 1327 英镑对 328 英镑,第 2 年为 1196 英镑对 337 英镑,第 3 年为 1148 英镑对 316 英镑,第 4 年为 1126 英镑对 325 英镑,第 5 年为 1112 英镑对 361 英镑)。
英国常规实践中诊断性 ADHD 的患病率明显低于之前的报告,自 2007 年以来,初级保健中诊断性 ADHD 的患病率和发病率均有所下降。ADHD 患者的经济成本是无 ADHD 患者的四倍多。