Horlin Chiara, Falkmer Marita, Parsons Richard, Albrecht Matthew A, Falkmer Torbjorn
School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, Australia.
School of Occupational Therapy & Social Work, CHIRI, Curtin University, Perth, Australia; School of Education and Communication, CHILD Programme, Institute of Disability Research, Jönköping University, Jönköping, Sweden.
PLoS One. 2014 Sep 5;9(9):e106552. doi: 10.1371/journal.pone.0106552. eCollection 2014.
A diagnosis of an autism spectrum disorders is usually associated with substantial lifetime costs to an individual, their family and the community. However, there remains an elusive factor in any cost-benefit analysis of ASD diagnosis, namely the cost of not obtaining a diagnosis. Given the infeasibility of estimating the costs of a population that, by its nature, is inaccessible, the current study compares expenses between families whose children received a formal ASD diagnosis immediately upon suspecting developmental atypicality and seeking advice, with families that experienced a delay between first suspicion and formal diagnosis.
A register based questionnaire study covering all families with a child with ASD in Western Australia.
Families with one or more children diagnosed with an ASD, totalling 521 children diagnosed with an ASD; 317 records were able to be included in the final analysis.
The median family cost of ASD was estimated to be AUD $34,900 per annum with almost 90% of the sum ($29,200) due to loss of income from employment. For each additional symptom reported, approximately $1,400 cost for the family per annum was added. While there was little direct influence on costs associated with a delay in the diagnosis, the delay was associated with a modest increase in the number of ASD symptoms, indirectly impacting the cost of ASD.
A delay in diagnosis was associated with an indirect increased financial burden to families. Early and appropriate access to early intervention is known to improve a child's long-term outcomes and reduce lifetime costs to the individual, family and society. Consequently, a per symptom dollar value may assist in allocation of individualised funding amounts for interventions rather than a nominal amount allocated to all children below a certain age, regardless of symptom presentation, as is the case in Western Australia.
自闭症谱系障碍的诊断通常会给个人、其家庭和社区带来巨大的终生成本。然而,在自闭症谱系障碍诊断的任何成本效益分析中,仍存在一个难以捉摸的因素,即未获得诊断的成本。鉴于估计本质上难以接触到的人群的成本不可行,本研究比较了那些孩子在怀疑发育异常并寻求建议后立即获得正式自闭症谱系障碍诊断的家庭与那些在首次怀疑和正式诊断之间经历延迟的家庭的费用。
一项基于登记册的问卷调查研究,涵盖西澳大利亚州所有有自闭症谱系障碍患儿的家庭。
有一个或多个被诊断患有自闭症谱系障碍的孩子的家庭,共有521名被诊断患有自闭症谱系障碍的儿童;317份记录能够纳入最终分析。
自闭症谱系障碍家庭的年成本中位数估计为34,900澳元,其中近90%(29,200澳元)是由于就业收入损失。每多报告一种症状,家庭每年的成本大约增加1,400澳元。虽然诊断延迟对相关成本几乎没有直接影响,但延迟与自闭症谱系障碍症状数量的适度增加有关,间接影响了自闭症谱系障碍的成本。
诊断延迟与家庭间接增加的经济负担有关。已知早期和适当地获得早期干预可改善儿童的长期预后,并降低个人、家庭和社会的终生成本。因此,按症状计算的美元价值可能有助于为干预措施分配个性化的资金数额,而不是像西澳大利亚州那样,为所有低于特定年龄的儿童分配名义金额,而不考虑症状表现。