Autism's cost
New numbers are shedding light on just how much it costs to care for children with autism — and, importantly, what is driving those costs. At a time when economic pressures are forcing families and government to make tough choices about how to spend their healthcare dollars, these kinds of data are invaluable.
A new study concludes that children with autism generate six-fold greater Medicaid costs than do typically developing children enrolled in the program. Medicaid is a national healthcare program for people with low incomes or disabilities.
The analysis falls in line with previous estimates of the economic costs of autism, by one of the new study’s authors, suggesting that medical expenditures are three to nine times higher for children with the disorder than for typically developing children.
But the researchers also show that healthcare costs vary widely, depending on whether a child has conditions that commonly occur alongside autism, specifically intellectual disability, attention deficit and hyperactivity disorder (ADHD) and epilepsy. This is the first study to look at how co-occurring conditions influence the cost of caring for children with autism enrolled in Medicaid, the researchers say.
Published last month in the Journal of Developmental & Behavioral Pediatrics, it analyzed Medicaid information from 8,398 children diagnosed with autism and nearly 1.5 million controls collected from eight unidentified states between 2003 and 2005.
Researchers found that just under half of children with autism have at least one of the other conditions. ADHD is the most common, affecting about 30 percent of that group.
Although mean medical costs for children with autism were six times higher than for controls, treating children with autism and intellectual disability cost 2.7 times more than treating those with a diagnosis of autism alone. Caring for children with both autism and ADHD is also more costly, by about 30 percent.
The researchers caution that their results may be skewed toward children with more severe forms of autism, because these children are more likely to be eligible for Medicaid. About 50 percent of the autism group was enrolled in Medicaid due to a disability (rather than family income), compared with only 5 percent of the control group.
The new findings reinforce the conclusions of another study, published in November 2010, that we blogged about early last year, showing that healthcare costs for autism are rising faster than for any other mental disorder.
It found that autism-related health costs grew more than 30 percent from 2000 to 2003, largely due to the disorder’s growing prevalence. According to the analysis, the number of children with an autism diagnosis rose nearly 30 percent in that time.
Taken together, the findings of these two studies show how challenging it is to calculate healthcare costs associated with specific disorders. Whereas the new study estimates the average medical expenditures for a year of care for a child with autism at roughly $10,000, the previous study put that figure at about $22,000.
The discrepancy may come from differences in state Medicaid coverage. For example, only some states cover behavioral therapies.
Having accurate estimates of these costs is crucial for making policy decisions, especially as states struggle to find revenue to support healthcare.
Just as important is determining the most effective ways to spend valuable healthcare dollars in helping children with autism, easing the burden on cash-strapped states and parents.
Fortunately, new research is beginning to help here, too. For example, a study published in the January issue of Archives of Pediatrics and Adolescent Medicine found that better access to community-based interventions lowers the chance of hospitalization for children with autism.
Analyzing Medicaid data collected in 2004 from nearly 30,000 children with autism, the researchers found that each $1,000 increase in spending on respite care, which provides temporary relief for caregivers, during the preceding 60 days resulted in an eight percent decrease in the odds of a child with autism ending up in the hospital.
Surprisingly, the use of therapeutic services, such as behavioral therapy, didn’t decrease hospitalization rates, raising concerns about whether these services are truly effective.
Comments
Drugs for behavior and Psychiatric institutionalization are extraordinary expenses. I would be interested to know what the costs were outside of psychiatric care. Epilepsy is indicative of brain disease or damage, of course, and is treated medically.
Love the attitude regarding decrease in hospitalization being indicated by respite care over ABA.
Yes, I believe the researchers included all medications covered by Medicaid in the analysis.
By the way, was ABA considered part of medical costs?
If so: well,there ya go!
According to the paper, the therapies they analyzed (based on Medicaid codes) included "one-to-one and group services for speech, occupational, physical, behavioral, talk, and family therapies."
The real message here is that autism costs a tremendous amount to manage. We will of course be hearing a lot more about a disorder whose cause remains a mystery to officials. Harvard estimates from 2006 said that the average lifetime care cost for one person with autism is $3.2 million. Others found that to be a gross underestimate. This article didn’t even mention the exponential increase in autism from being a once-rare disorder to one so common that everyone knows someone with an affected child. The autism rate is now one percent of children and almost two percent for just boys alone. That statistic comes from outdated studies of eight year olds in 2006. Those kids are teenagers now. No one at the CDC has bothered to update the numbers. One thing is clear, when we talk about autism, we're always talking about CHILDREN WITH AUTISM. No one has ever found a comparable rate among adults. We are just beginning to pay for autism. As more and more children with autism age into adulthood we'll see that the cost of autism is going to be an economic nightmare for the U.S.
Anne Dachel, Media editor: Age of Autism
I have a son that is 6 yearsold that has Autism and I am a single parent trying to raise him pluse a 3 yr. old Idrive 2 hrs to work week-ends so my Mom and Dad can keep him I work 12 hr. shifts on week-ends it is very tiring and very expensive but cannot work through the week because the school is calling all the time to come and get him because he is sick or something is wrong,I don't have any ideal what I am going to do,I am having a lot of finacinals problems.His Dad won't have anything to do with him he might come 1 time a year and see him for 15 min.
The cost are so high because all of us parents are so desperate for a cure or improvements. The "specialist" are all out of pocket or PPO providers. And we pay out of pocket. With the growing numbers we need something. All these individual Autism fundraising and supporting groups need to get together with a plan. I'm quickly thinking clinics from food advice to health care your research can be combined with providing services for us. My son is 16 now he has several auto immune issues incuding autism, alopecia and Eosinophilic esophagitis and it is so depressing. I spent years trying to make money to pay for all these different things that were suppose to help him and really we are no where closer to improvement of his overall quality of life then when we started. We need a big picture solutions and some real heros to step up! If you are trying to make a "profit" off of Autism really look at yourself and your purpose and make a change!
You really could have made it easier to find the articles you are talking about here. Please write out the authors' names and affiliations and a citation for each article, instead of just linking to them within the text.
i 'saved' my job and my own health by bringing my son home from school on a full time basis. I was being called away from work 7-8 times a week. yes, sometimes twice a day. at home he got more OT just from eight or more hours a day running and clmbing in the back yard than he got at school, he needed no meds, and there were only a handful of meltdowns compared to 2-3 hours after school daily. it won't necessarily work for everyone, but it's worth some consideration. if i'd only gotten paid what his one-on-one at school was paid... i don't think that vocational planning is taken seriously, or that proper environment is also key. my kiddo (autism and ADHD with three other conditions) was never able to spend a full day in the bright lights and noise at public school, but years later he's in college and only has to 'entertain' those items (and not so much boistrous noise, of course) for three hours a day. hmmmm. is part of the cost attributable to forcing square pegs into round holes?
I love you, lady fern. My son is mild, the type so much future planning of the DSM5 is being spent on. I'm sure we can drive the whole generation crazy if we work it right...
My concern is for kids who aren't able to even live at home, whose behavior is so difficult the parents may lose heart without a respite, and whose futures are uncertain once their advocates die. Abuse is rampant among their "carers". And it is very expensive for anyone who is institionalized.