Institute of Heath Policy, Management and Evaluation, University of Toronto, Toronto, Canada.
Program of Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, Canada.
J Autism Dev Disord. 2018 Sep;48(9):2968-2979. doi: 10.1007/s10803-018-3571-4.
The American Academy of Pediatrics recommends universal screening for autism spectrum disorder at 18 and 24 months. This study compared the cost-effectiveness of universal or high-risk screening to surveillance monitoring. Simulation models estimated the costs and outcomes from birth to age 6 years. The incremental cost per child diagnosed by 36 months was $41,651.6 for high-risk screening and $757,116.9 for universal screening from the societal perspective. Universal screening may not be a cost-effective approach to increase earlier treatment initiation, as most children initiated treatment after age 60 months. Eliminating wait times resulted in more children initiated treatment by 48 months, but at a high initial cost that may be offset by future cost-savings related to better outcomes.
美国儿科学会建议在 18 个月和 24 个月时对自闭症谱系障碍进行普遍筛查。本研究比较了普遍筛查和高风险筛查与监测监测的成本效益。仿真模型估计了从出生到 6 岁的成本和结果。从社会角度来看，通过 36 个月诊断出每个儿童的增量成本分别为高危筛查 41651.6 美元和普遍筛查 757116.9 美元。普遍筛查可能不是增加早期治疗启动的一种具有成本效益的方法，因为大多数儿童在 60 个月后才开始治疗。消除等待时间使更多的儿童在 48 个月时开始治疗，但初始成本很高，这可能会被未来与更好的结果相关的成本节约所抵消。
