Mora Toni, Puig-Junoy Jaume, Jacobs Rowena, Cid Jordi
Research Institute for Evaluation and Public Policies (IRAPP), Universitat Internacional de Catalunya (UIC), Barcelona, 08017, Spain.
Universitat Pompeu Fabra-Barcelona School of Management (UPF-BSM), Barcelona, Spain.
Health Econ Rev. 2023 Apr 22;13(1):24. doi: 10.1186/s13561-023-00437-8.
Attention-Deficit/Hyperactivity Disorder (ADHD) is young children's most common mental health disorder. We aim to provide causal estimates of the differential costs for the non-adult population with ADHD. We used longitudinal administrative data covering the non-adult population over five years and different healthcare providers (general practitioners, hospitalisations and emergency departments, visits to mental healthcare centres-day-care or hospitals) of 1,101,215 individuals in Catalonia (Spain). We also include the consumption of pharmaceuticals and cognitive therapies. We instrumented ADHD diagnosis by the probability of being diagnosed by the most visited healthcare provider based on individual monthly visits to the provider in which this visit was related to ADHD and the density of professionals in the different mental health providers. After using matching procedures to include a proper control group, we estimated two-part and finite mixture models. Our results indicate that ADHD children and adolescents displayed 610€ higher annual health direct costs compared to not diagnosed counterparts. We provide average costs disentangling the sample by age boundaries, gender, and comorbidities to offer values for cost-effective analyses and incremental costs after diagnosis, which is around 400€. A significant differential annual direct health cost for the non-adult population with ADHD is determined, which will be helpful for cost-effectiveness analysis and complete cost-of-illness studies.
注意力缺陷/多动障碍（ADHD）是幼儿最常见的心理健康障碍。我们旨在对患有ADHD的非成人人群的差异成本进行因果估计。我们使用了涵盖五年内非成人人群以及西班牙加泰罗尼亚地区1,101,215人的不同医疗服务提供者（全科医生、住院治疗和急诊科、前往心理保健中心——日托或医院就诊）的纵向行政数据。我们还纳入了药品和认知疗法的消费情况。我们根据个体每月前往与ADHD相关的医疗服务提供者就诊的情况以及不同心理健康服务提供者中的专业人员密度，通过就诊最多的医疗服务提供者做出诊断的概率来确定ADHD诊断。在使用匹配程序纳入合适的对照组后，我们估计了两部分模型和有限混合模型。我们的结果表明，与未被诊断出ADHD的同龄人相比，患有ADHD的儿童和青少年每年的直接医疗成本高出610欧元。我们按年龄界限、性别和合并症对样本进行分解，提供平均成本，以便为成本效益分析和诊断后的增量成本提供数值，增量成本约为400欧元。确定了患有ADHD的非成人人群每年显著的直接医疗成本差异，这将有助于成本效益分析和完整的疾病成本研究。
