Autism spectrum disorders and health care expenditures: the effects of co-occurring conditions

J Dev Behav Pediatr. 2012 Jan;33(1):2-8. doi: 10.1097/DBP.0b013e31823969de.


Objective: Children with autism spectrum disorders (ASDs) often have co-occurring conditions, but little is known on the effect of those conditions on their medical care cost. Medical expenditures attributable to ASDs among Medicaid-enrolled children were calculated, and the effects of 3 commonly co-occurring conditions--intellectual disability (ID), attention deficit/hyperactivity disorder (ADHD), and epilepsy-on those expenditures were analyzed.

Methods: Using MarketScan Medicaid Multi-State Databases (2003-2005) and the International Classification of Disease, Ninth Revision, children with ASD were identified. Children without ASD formed the comparison group. The 3 co-occurring conditions were identified among both the ASD and the comparison groups. Annual mean, median, and 95th percentile of total expenditures were calculated for children with ASD and the co-occurring conditions and compared with those of children without ASD. Multivariate analyses established the influence of each of those co-occurring conditions on the average expenditures for children with and without ASD.

Results: In 2005, 47% of children with ASD had at least 1 selected co-occurring condition; attention deficit/hyperactivity disorder was the most common, at 30%. The mean medical expenditures for children with ASD were 6 times higher than those of the comparison group. Children with ASD and ID incurred expenditures 2.7 times higher than did children with ASD and no co-occurring condition.

Conclusion: Medicaid-enrolled children with ASD incurred higher medical costs than did Medicaid-enrolled children without ASD. Among Medicaid-enrolled children with ASD, cost varied substantially based on the presence of another neurodevelopmental disorder. In particular, children with ID had much higher costs than did other children with ASD.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Attention Deficit Disorder with Hyperactivity / complications
  • Attention Deficit Disorder with Hyperactivity / economics
  • Attention Deficit Disorder with Hyperactivity / epidemiology
  • Child
  • Child Development Disorders, Pervasive / complications*
  • Child Development Disorders, Pervasive / economics*
  • Child Development Disorders, Pervasive / epidemiology
  • Child, Preschool
  • Comorbidity
  • Epilepsy / complications
  • Epilepsy / economics
  • Epilepsy / epidemiology
  • Female
  • Health Expenditures* / classification
  • Humans
  • Infant
  • Intellectual Disability / complications
  • Intellectual Disability / economics
  • Intellectual Disability / epidemiology
  • Male
  • Medicaid / economics
  • Registries
  • United States / epidemiology