Service Delivery

Medical service utilization and costs of autism spectrum disorder: Evidence from hospital records in Beijing, China.

Zhao et al. (2023) · Autism research : official journal of the International Society for Autism Research 2023
★ The Verdict

Hospital costs for autism rise steeply with age, driven by medication in adults and diagnostics in kids.

✓ Read this if BCBAs who help families plan long-term care or talk with doctors about meds.
✗ Skip if Clinicians who only run early-intervention home programs and never touch medical teams.

01Research in Context

01

What this study did

Zhao et al. (2023) pulled 26,826 autism files from Beijing hospitals. They counted every outpatient and inpatient bill to see how much families spend.

The team split the group by age to watch how costs change as kids grow up.

02

What they found

Most families paid about $422 per year for outpatient visits. Only one in a hundred needed inpatient care, but that bill jumped to $4,412.

Medication ate most of the adult budget. For kids, tests and therapy took the biggest slice.

03

How this fits with other research

Croteau et al. (2019) saw the same cost climb in Canada. After diagnosis, visits dropped yet drug costs stayed high.

Cidav et al. (2013) tracked U.S. Medicaid kids and found costs also rose with age. Beijing data now show the same uphill line in China.

Järbrink (2007) counted wider family costs in Sweden, like extra care hours. Yanan focuses only on hospital bills, so the true price tag is still larger.

04

Why it matters

You now know the money pain hits older clients hardest. When you write treatment plans, weigh drug needs against cheaper skill-building hours. Push for early, community-based therapy before the medication share grows.

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Add a cost-check question to your intake: 'Are drug costs rising each year?' If yes, schedule a med review with the prescribing doctor.

02At a glance

Intervention
not applicable
Design
other
Sample size
26826
Population
autism spectrum disorder
Finding
not reported

03Original abstract

As more and more people are diagnosed with autism spectrum disorder (ASD), it is necessary to better understand their costs. Detailed information on medical service utilization and costs could aid in designing equitable, effective policies to support individuals with ASD and their families. In this retrospective analysis, individuals with a hospital encounter (outpatient visit or inpatient admission) were collected from Beijing Municipal Health Big Data and Policy Research Center (BMHBD), from January 1, 2017 to December 31, 2021. We analyzed the costs, hospital visits/admissions and their changing trends over 5 years. Poisson regression and logit regression were conducted to analyze the influencing factors of visits, admissions and costs. The study population consisted of 26,826 users of medical services (26,583 outpatients and 243 inpatients; mean age: 4.82 ± 3.47 years for outpatients; 11.62 ± 6.74 years for inpatients). 99.1% were outpatients (mean ± standard deviation (SD) costs per year: $422.06 ± $11.89), while 0.9% were inpatients (mean ± SD costs per year: $4411.71 ± $925.81). More than 50% of outpatients received medication and diagnostic testing services. Among those with an inpatient admission, 91% received treatment services. Medication costs were the major contributor to medical costs for adults. Diagnostic test and treatment costs were the major contributors for children and adolescents. The findings demonstrated a significant economic burden for those diagnosed with ASD and highlighted opportunities for improving the care of this vulnerable group. This study adds to the literature by focusing on age differences among health-care utilization in individuals with ASD.

Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1002/aur.2970