Skip to main content

Advertisement

SpringerLink
Log in

Age-Related Variation in Health Service Use and Associated Expenditures Among Children with Autism

  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

This study examined differences by age in service use and associated expenditures during 2005 for Medicaid-enrolled children with autism spectrum disorders. Aging was associated with significantly higher use and costs for restrictive, institution-based care and lower use and costs for community-based therapeutic services. Total expenditures increased by 5 % with each year of age; by 23 % between 3–5 and 6–11 year olds, 23 % between 6–11 and 12–16, and 14 % between 12–16 and 17–20 year olds. Use of and expenditures for long-term care, psychiatric medications, case management, medication management, day treatment/partial hospitalization, and respite services increased with age; use of and expenditures for occupational/physical therapy, speech therapy, mental health services, diagnostic/assessment services, and family therapy declined.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aman, M., Lam, K., et al. (2003). Prevalence and patterns of use of psychoactive medicines among individuals with autism in the Autism Society of Ohio. Journal of Autism and Developmental Disorders, 33(5), 527–534.

    Article  PubMed  Google Scholar 

  • Amendah, D., Grosse, S., et al. (2011). The economic costs of autism: A review. In D. Amaral, G. Dawson, & D. Geschwind (Eds.), Autism spectrum disorders. New York: Oxford University Press.

  • CMS (2011). Report on state services to individuals with autism spectrum disorders. Centers for Medicare & Medicaid Services ASD Services Project.

  • Croen, L., Najjar, D., et al. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118(4), e1203–1211.

    Article  PubMed  Google Scholar 

  • Fombonne, E., Heavey, L., et al. (2004). Validation of the diagnosis of autism in general practitioner records. BMC Public Health, 4(Article 5).

  • Ganz, M. (2006). The costs of autism. In S. Moldin & J. Rubenstein (Eds.), Understanding autism: From basic neuroscience to treatment Boca Raton. FL: CRC Press.

    Google Scholar 

  • Ganz, M. (2007). The lifetime distribution of the incremental societal costs of autism. Archives of Pediatrics and Adolescent Medicine, 161(4), 343–349.

    Article  PubMed  Google Scholar 

  • Grether, J., Rosen, N., et al. (2009). Investigation of shifts in autism reporting in the California department of developmental services. Journal of Autism and Developmental Disorders, 39(10), 1412–1419.

    Article  PubMed  Google Scholar 

  • Gurney, J., McPheeters, M., et al. (2006). Parental report of health conditions and health care use among children with and without autism: National survey of children’s health. Archives of Pediatrics and Adolescent Medicine, 160(8), 825–830.

    Article  PubMed  Google Scholar 

  • Howlin, P., & Goode, S. (1998). Outcome in adult life for individuals with autism. In F. Volkmar (Ed.), Autism and developmental disorders. New York: Cambridge University Press.

    Google Scholar 

  • Howlin, P., Goode, S., et al. (2004). Adult outcome for children with autism. Journal of Child Psychology and Psychiatry, 45(2), 212–237.

    Article  PubMed  Google Scholar 

  • Kang, T., & Harrington, C. (2008). Variation in types of service use and expenditures for individuals with developmental disabilities. Disability and Health Journal, 1(1), 30–41.

    Article  PubMed  Google Scholar 

  • Leslie, D., & Martin, A. (2007). Health care expenditures associated with autism spectrum disorders. Archives of Pediatrics and Adolescent Medicine, 161(4), 350–355.

    Article  PubMed  Google Scholar 

  • Levy, S. E., Giarelli, E., et al. (2010). Autism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations of the United States. Journal of Developmental and Behavioral Pediatrics, 31(4), 267–275.

    Article  PubMed  Google Scholar 

  • Liptak, G., Stuart, T., et al. (2006). Health care utilization and expenditures for children with autism: Data from US national samples. Journal of Autism and Developmental Disorders, 36, 871–879.

    Article  PubMed  Google Scholar 

  • Logan, S., Nicholas, J., et al. (2012). High prescription drug use and associated costs among Medicaid-eligible children with autism spectrum disorders identified by a population-based surveillance network. Annals of Epidemiology, 22(1), 1–8.

    Article  PubMed  Google Scholar 

  • Lokhandwala, T., Khanna, R., et al. (2012). Hospitalization burden among individuals with autism. Journal of Autism and Developmental Disorders, 42(1), 95–104.

    Article  PubMed  Google Scholar 

  • Lord, C., Risi, S., et al. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63(6), 649–701.

    Article  Google Scholar 

  • Lurie, N., Popkin, M., et al. (1992). Accuracy of diagnoses of schizophrenia in Medicaid claims. Hospital & Community Psychiatry, 43(1), 69–71.

    Google Scholar 

  • Mandell, D. (2008). Psychiatric hospitalization among children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 38(6), 1059–1065.

    Article  PubMed  Google Scholar 

  • Mandell, D., Cao, J., et al. (2006). Medicaid expenditures for children with autistic spectrum disorders: 1994 to 1999. Journal of Autism and Developmental Disorders, 36(4), 475–485.

    Article  PubMed  Google Scholar 

  • Mandell, D., Listerud, J., et al. (2002). Race differences in the age at diagnosis among Medicaid-eligible children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 41(12), 1447–1453.

    Article  PubMed  Google Scholar 

  • Mandell, D., Machefsky, A., et al. (2008a). Medicaid’s role in financing health care for children with behavioral health care needs in the special education system: Implications of the deficit reduction act. Journal of School Health, 78(10), 532–538.

    Article  PubMed  Google Scholar 

  • Mandell, D., Morales, K., et al. (2008b). Psychotropic medication use among Medicaid-enrolled children with autism spectrum disorders. Pediatrics, 121(3), E441–E448.

    Article  PubMed  Google Scholar 

  • Mandell, D., Xie, M., et al. (2012). The interplay of outpatient services and psychiatric hospitalization among Medicaid-enrolled children with autism spectrum disorders. Archives of Pediatrics and Adolescent Medicine, 166(1), 68–73.

    Article  PubMed  Google Scholar 

  • Newschaffer, C., & Curran, L. (2003). Autism: An emerging public health problem. Public Health Reports, 118(5), 393–399.

    PubMed  Google Scholar 

  • Oswald, D., & Sonenklar, N. (2007a). Medication use among children with autism spectrum disorders. J Child Adolesc Psychopharmacol, 17(3), 348–355.

    Article  PubMed  Google Scholar 

  • Oswald, D. P., & Sonenklar, N. A. (2007b). Medication use among children with autism-spectrum disorders. Journal of Child and Adolescent Psychopharmacology, 17(3), 348–355.

    Article  PubMed  Google Scholar 

  • Peacock, G., Amendah, D., et al. (2012). Autism spectrum disorders and health care expenditures: The effects of co-occurring conditions. Journal of Developmental and Behavioral Pediatrics, 33(1), 2–8.

    Article  PubMed  Google Scholar 

  • Pruchno, R. A., & McMullen, W. F. (2004). Patterns of service utilization by adults with a developmental disability: Type of service makes a difference. American Journal on Mental Retardation, 109(5), 362–378.

    Article  PubMed  Google Scholar 

  • Rosenberg, R. E., Mandell, D. S., et al. (2010). Psychotropic medication use among children with autism spectrum disorders enrolled in a national registry, 2007–2008. Journal of Autism and Developmental Disorders, 40(3), 342–351.

    Article  PubMed  Google Scholar 

  • Ruble, L., Heflinger, C., et al. (2005). Access and service use by children with autism spectrum disorders in Medicaid managed care. Journal of Autism and Developmental Disorders, 35(1), 3–13.

    Article  PubMed  Google Scholar 

  • Seltzer, M., Shattuck, P., et al. (2004). Trajectory of development in adolescents and adults with autism. Mental Retardation and Developmental Disabilities Research Reviews, 10, 234–347.

    Article  PubMed  Google Scholar 

  • Shattuck, P., Seltzer, M., et al. (2006). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1735–1747.

    Article  PubMed  Google Scholar 

  • Shattuck, P., Seltzer, M., et al. (2007). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37, 1735–1747.

    Article  PubMed  Google Scholar 

  • Shattuck, P., Wagner, M., et al. (2011). Post-high school service use among young adults with an autism spectrum disorder. Archives of Pediatrics and Adolescent Medicine, 165(2), 141–146.

    Article  PubMed  Google Scholar 

  • Shimabukuro, T., Grosse, S., et al. (2008). Medical expenditures for children with an autism spectrum disorder in a privately insured population. Journal of Autism and Developmental Disorders, 38(3), 546–552.

    Article  PubMed  Google Scholar 

  • Stahmer, A., & Mandell, D. (2007). State infant/toddler program policies for eligibility and services provision for young children with autism. Administration and Policy in Mental Health, 34(1), 29–37.

    Article  PubMed  Google Scholar 

  • Tidmarsh, L., & Volkmar, F. (2003). Diagnosis and epidemiology of autism spectrum disorders. Canadian Journal of Psychiatry, 48, 517–525.

    Google Scholar 

  • USDHHS (2009). Medicaid managed care encounter data: Collection and use. United States Department of Health and Human Services Office of Inspector General.

  • Wang, L., & Leslie, D. (2011). Psychotropic medication use among children with autism spectrum disorder: A comparison between Medicaid and commercial insurance. Value in Health, 14(3), A189–A189.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Mental Health Policy & Services Research, Center for Autism Research, Perelman School of Medicine at the University of Pennsylvania, The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Zuleyha Cidav, Lindsay Lawer & David S. Mandell

  2. Center for Health Equity Research & Promotion, Philadelphia Veterans Affairs Medical Center, School of Social Policy & Practice, University of Pennsylvania, Philadelphia, PA, USA

    Steven C. Marcus

Authors
  1. Zuleyha Cidav
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lindsay Lawer
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Steven C. Marcus
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. David S. Mandell
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Zuleyha Cidav.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Cidav, Z., Lawer, L., Marcus, S.C. et al. Age-Related Variation in Health Service Use and Associated Expenditures Among Children with Autism. J Autism Dev Disord 43, 924–931 (2013). https://doi.org/10.1007/s10803-012-1637-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-012-1637-2

Keywords

Search

Navigation