Gupte-Singh Komal, Singh Rakesh R, Lawson Kenneth A
Health Outcomes and Pharmacy Practice Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.
Health Outcomes and Pharmacy Practice Division, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.
Value Health. 2017 Apr;20(4):602-609. doi: 10.1016/j.jval.2017.01.007.
To determine the adjusted incremental total costs (direct and indirect) for patients (aged 3-17 years) with attention-deficit/hyperactivity disorder (ADHD) and the differences in the adjusted incremental direct expenditures with respect to age groups (preschoolers, 0-5 years; children, 6-11 years; and adolescents, 12-17 years).
The 2011 Medical Expenditure Panel Survey was used as the data source. The ADHD cohort consisted of patients aged 0 to 17 years with a diagnosis of ADHD, whereas the non-ADHD cohort consisted of subjects in the same age range without a diagnosis of ADHD. The annual incremental total cost of ADHD is composed of the incremental direct expenditures and indirect costs. A two-part model with a logistic regression (first part) and a generalized linear model (second part) was used to estimate the incremental costs of ADHD while controlling for patient characteristics and access-to-care variables.
The 2011 Medical Expenditure Panel Survey database included 9108 individuals aged 0 to 17 years, with 458 (5.0%) having an ADHD diagnosis. The ADHD cohort was 4.90 times more likely (95% confidence interval [CI] 2.97-8.08; P < 0.001) than the non-ADHD cohort to have an expenditure of at least $1, and among those with positive expenditures, the ADHD cohort had 58.4% higher expenditures than the non-ADHD cohort (P < 0.001). The estimated adjusted annual total incremental cost of ADHD was $949.24 (95% CI $593.30-$1305.18; P < 0.001). The adjusted annual incremental total direct expenditure for ADHD was higher among preschoolers ($989.34; 95% CI $402.70-$1575.98; P = 0.001) than among adolescents ($894.94; 95% CI $428.16-$1361.71; P < 0.001) or children ($682.71; 95% CI $347.94-$1017.48; P < 0.001).
Early diagnosis and use of evidence-based treatments may address the substantial burden of ADHD.
确定注意力缺陷多动障碍（ADHD）患者（3 - 17岁）调整后的增量总成本（直接和间接），以及各年龄组（学龄前儿童，0 - 5岁；儿童，6 - 11岁；青少年，12 - 17岁）调整后的增量直接支出差异。
使用2011年医疗支出面板调查作为数据源。ADHD队列由0至17岁被诊断为ADHD的患者组成，而非ADHD队列由同一年龄范围内未被诊断为ADHD的受试者组成。ADHD的年度增量总成本由增量直接支出和间接成本组成。采用包含逻辑回归（第一部分）和广义线性模型（第二部分）的两部分模型来估计ADHD的增量成本，同时控制患者特征和就医可及性变量。
2011年医疗支出面板调查数据库包含9108名0至17岁的个体，其中458名（5.0%）被诊断为ADHD。ADHD队列至少支出1美元的可能性是非ADHD队列的4.90倍（95%置信区间[CI] 2.97 - 8.08；P < 0.001），在有正支出的人群中，ADHD队列的支出比非ADHD队列高58.4%（P < 0.001）。ADHD估计调整后的年度总增量成本为949.24美元（95% CI 593.30 - 1305.18美元；P < 0.001）。ADHD调整后的年度增量总直接支出在学龄前儿童中（989.34美元；95% CI 402.70 - 1575.98美元；P = 0.001）高于青少年（894.94美元；95% CI 428.16 - 1361.71美元；P < 0.001）或儿童（682.71美元；95% CI 347.94 - 1017.48美元；P < 0.001）。
早期诊断和使用循证治疗可能有助于解决ADHD的沉重负担。
