Douglas L Leslie1, Andrés Martin. 1. Department of Psychiatry, Yale University School of Medicine, West Haven, CT 06516, USA. douglas.leslie@yale.edu
Abstract
OBJECTIVE: To examine the health care expenditures associated with autism spectrum disorders (ASDs) in medical care settings. DESIGN: Retrospective analysis of health insurance claims data. SETTING: Administrative claims database for a national sample of privately insured individuals. PARTICIPANTS: Children and adolescents 17 years and younger with a diagnosis of a mental disorder between 2000 and 2004. MAIN OUTCOME MEASURES: Annual inpatient, outpatient, and prescription drug expenditures. RESULTS: Average health care expenditures for individuals with an ASD increased 20.4% from $4965 per patient in 2000 to $5979 per patient in 2004, even after adjustment for inflation. When combined with rising ASD prevalence rates, total expenditures per 10 000 covered lives associated with ASDs increased 142.1% over the 5-year period. Although total expenditures per treated patient were higher for patients with ASDs than for individuals with other mental disorders, ASDs created a smaller burden on health insurers because of their relatively low treated prevalence. CONCLUSIONS: In light of anticipated patterns of earlier identification and more proactive treatment of ASDs in the years to come, the burden of autism on the health care system will continue to increase. Efforts should be made to ensure that access to care for this vulnerable population is not compromised.
OBJECTIVE: To examine the health care expenditures associated with autism spectrum disorders (ASDs) in medical care settings. DESIGN: Retrospective analysis of health insurance claims data. SETTING: Administrative claims database for a national sample of privately insured individuals. PARTICIPANTS: Children and adolescents 17 years and younger with a diagnosis of a mental disorder between 2000 and 2004. MAIN OUTCOME MEASURES: Annual inpatient, outpatient, and prescription drug expenditures. RESULTS: Average health care expenditures for individuals with an ASD increased 20.4% from $4965 per patient in 2000 to $5979 per patient in 2004, even after adjustment for inflation. When combined with rising ASD prevalence rates, total expenditures per 10 000 covered lives associated with ASDs increased 142.1% over the 5-year period. Although total expenditures per treated patient were higher for patients with ASDs than for individuals with other mental disorders, ASDs created a smaller burden on health insurers because of their relatively low treated prevalence. CONCLUSIONS: In light of anticipated patterns of earlier identification and more proactive treatment of ASDs in the years to come, the burden of autism on the health care system will continue to increase. Efforts should be made to ensure that access to care for this vulnerable population is not compromised.
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