Table 5.
Health care Costs for Adults with Autism Spectrum Disorder, Attention-Deficit and Hyperactivity Disorder, and General Population Controls, Kaiser Permanente Northern California, 2012
| ASD (N = 1507) | ADHD (N = 9042) | GP (N = 15070) | Adjusted mean ratios a (95% CI) | |||||
|---|---|---|---|---|---|---|---|---|
| Mean cost (SD) | Median cost (IQR) | Mean cost (SD) | Median cost (IQR) | Mean cost (SD) | Median cost (IQR) | ASD vs. ADHD | ASD vs. GP | |
| Overall costb | 7118.7 (15647.8) | 2520 (716, 6949) | 5876.7 (17916.2) | 1984 (652, 5043) | 3197.3 (17480.9) | 806.0 (120, 2140) | 1.2 (1.1–1.3) | 1.7 (1.6–1.9) |
| Any outpatient clinic | 2955.9 (5773.2) | 1455 (499, 3310) | 2546.7 (5405.11) | 1224 (342, 2943) | 1407.2 (4616.1) | 655.0 (0, 1545) | 1.1 (1.0–1.2) | 1.6 (1.5–1.7) |
| Primary care | 946.8 (1616.6) | 491 (149, 1130) | 829.6 (1416.2) | 342 (0, 1026) | 579.7 (1009.2) | 342.0 (0, 707) | 1.1 (1.0–1.2) | 1.2 (1.1–1.4) |
| Mental health/psychiatry | 1078.9 (2719.0) | 0 (0, 998) | 601.0 (1693.3) | 0 (0, 499) | 94.6 (663.2) | 0 (0, 0) | 1.8 (1.6–2.1) | 11.6 (10.2–13.1) |
| Neurology | 68.4 (373.4) | 0 (0, 0) | 42.0 (322.8) | 0 (0, 0) | 12.6 (124.8) | 0 (0, 0) | 1.8 (1.6–2.0) | 2.3 (2.1–2.6) |
| Ob/gyn | 248.0 (531.3) | 0 (0, 426) | 534.5 (1043.8) | 381 (0, 426) | 601.9 (1246.3) | 0 (0, 426) | 0.5 (0.4–0.6) | 0.4 (0.3–0.5) |
| Other specialties | 525.5 (2010.3) | 0 (0, 401) | 648.6 (1683.9) | 0 (0, 563) | 301.3 (1539.2) | 0 (0, 0) | 0.8 (0.7–0.9) | 1.0 (0.9–1.1) |
| Emergency department | 385.0 (1145.0) | 0 (0, 0) | 320.3 (1111.0) | 0 (0, 0) | 186.4 (766.6) | 0 (0, 0) | 0.9 (0.8–1.0) | 1.1 (1.0–1.3) |
| Hospitalizations | 1762.6 (9621.0) | 0 (0, 0) | 1735.2 (12914.3) | 0 (0, 0) | 1160.8 (14646.1) | 0 (0, 0) | 0.9 (0.8–1.0) | 1.0 (0.8–1.1) |
| Home health services | 138.6 (1556.2) | 0 (0, 0) | 61.1 (1657.6) | 0 (0, 0) | 33.3 (1636.4) | 0 (0, 0) | 16.2 (14.5–18.1) | 9.1 (8.1–10.2) |
| Skilled nursing | 18.7 (407.6) | 0 (0, 0) | 12.9 (525.4) | 0 (0, 0) | 4.7 (267.9) | 0 (0, 0) | 1.7 (1.6–1.9) | 2.5 (2.3–2.6) |
| Any medication | 1857.9 (7466.6) | 254 (26, 1387) | 1200.5 (3913.2) | 181 (17, 885) | 404.9 (2441.8) | 29 (0, 157) | 1.9 (1.7–2.1) | 4.5 (4.0–5.0) |
| Psychotherapeutic | 1013.6 (2857.9) | 43 (0, 310) | 324.8 (1204.3) | 0 (0, 90) | 37.0 (448.0) | 0 (0, 0) | 4.0 (3.5–4.5) | 26.3 (23.5–29.3) |
| Anticonvulsive | 162.9 (995.3) | 0 (0, 17) | 25.5 (328.2) | 0 (0, 0) | 8.2 (217.8) | 0 (0, 0) | 8.4 (7.6–9.4) | 23.5 (21.7–25.4) |
| Other medication | 681.4 (6796.7) | 56 (0, 261) | 850.2 (3633.7) | 97 (0, 476) | 359.7 (2374.2) | 27 (0, 137) | 0.8 (0.7–0.8) | 1.7 (1.5–1.9) |
All costs are in U.S. dollars and are adjusted to reflect 2016 costs.
Adjusted for gender, age, race/ethnicity, total length of KPNC membership, and nine categories of medical and psychiatric comorbidities (immune conditions, cardiovascular diseases, metabolic disorders, neurological disorders, gastrointestinal disorders, sleep disorders, psychiatric conditions, nutritional conditions, and endocrine conditions) identified with diagnosis codes for the primary and secondary reasons for visit.
Overall costs include all hospitalizations, emergency room visits, outpatient visits (including primary and specialty care), home health care, skilled nursing, and medications. Costs for durable medical equipment were not included.