The difference in medical utilization and associated factors between children and adolescents with and without autism spectrum disorders.
Expect roughly double the annual medical visits and NT$32,460 higher costs for each child with autism.
01Research in Context
What this study did
Wu et al. (2015) compared medical bills for kids with autism and matched peers. They used Taiwan's National Health Insurance claims to count every doctor visit and dollar spent in one year.
The team tracked children aged 5-11. Each child with autism was paired with a child of the same age and sex who did not have autism.
What they found
Kids with autism went to the doctor 14 more times per year. Their yearly health-care costs were NT$32,460 higher.
Most extra visits were for stomach, breathing, and mental-health issues. The gap stayed big even after matching for age and sex.
How this fits with other research
Dib et al. (2007) and Saral et al. (2023) also show high service use. They report that 74-88% of families try complementary or alternative medicine. These extra visits add to the total count Wu et al. (2015) found.
Bottema-Beutel et al. (2015) helps explain the jump in visits. They show kids with autism have double the rate of food allergies. These allergies can lead to stomach pain and more trips to the doctor.
Lin et al. (2013) used the same claims method for kids with ADHD. Both studies prove Taiwan's data can spotlight hidden cost drivers for neurodevelopmental groups.
Why it matters
Budget for twice as many medical visits per child with autism. Plan care-coordination time for stomach, breathing, and mental-health needs. Ask about food allergies and complementary treatments during intake so you can track all reasons families see doctors.
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02At a glance
03Original abstract
This study determined differences in health care utilization and health care expenditures between children with and without autism spectrum disorder (ASD) and examined possible reasons for these differences. A retrospective longitudinal study of children aged younger than 18 years both with and without ASD was conducted using the 2008 database of the Ministry of the Interior registry of the disabled persons in tandem with the National Health Insurance Research Database. Propensity score matching for the covariates of age, sex, and parental monthly salary was used to match children at a ratio of 1:3 for observing health care utilization among children with and without ASD from 2008 to 2011. Generalized estimating equation analysis was performed to determine factors that affect health care utilization, such as physician visits, emergency room (ER) visits, hospitalizations, and health care expenditures. After matching was completed, the sample size comprised 3280 children with ASD and 9840 children without ASD. Among the children in the sample, most were boys (86.68%) between the ages of 6-11 years, and the average age of both samples was 9.8 years. After relevant factors were controlled for, the children with ASD yielded an average of 14.2 more annual physician visits and were more likely to visit the ER (OR=1.12, P<.05) or be hospitalized (OR=1.48; P<.05) compared with the children without ASD. Compared with the children without ASD, the children with ASD exhibited higher annual physician visit expenditures (NT$26,580 more), higher ER visit expenditures (NT$50 more), higher hospitalization expenditures (NT$5830 more), and NT$32,460 more total health care expenditures (all P<.05). Significant predictors of health care expenditures among the children with ASD were age, parental monthly salary, and severity of comorbidity. The most common reasons for physician visits or hospitalizations among the children with ASD were psychiatric illnesses, respiratory illnesses, and digestive illnesses. The children without ASD most commonly experienced respiratory, digestive, and nervous system or sense organ illnesses. Health care utilization among children with ASD is higher than that among children without ASD. The results of this study can serve as a reference for governmental agencies enacting relevant health care policies.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2014.09.019