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Outpatient rehabilitation resources and medical expenditure in children with attention-deficit hyperactivity disorder

Hsing-Jung Li1,2, Chao-Chan Kuo3, Yi-Chien Yao2

  • 1Department of Child & Adolescent Psychiatry, Kai-Syuan Psychiatric Hospital, Kaohsiung City, Taiwan.

Plos One
|June 29, 2018
PubMed

Insights

Children with Attention-Deficit/Hyperactivity Disorder (ADHD) utilize more rehabilitation services, with clinics showing high usage but lower costs than hospitals. Early detection and treatment are crucial for better outcomes.

Area of Science:

  • Neurodevelopmental Disorders
  • Pediatric Rehabilitation
  • Healthcare Resource Utilization

Background:

  • Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder in children.
  • Understanding rehabilitation treatment patterns is essential for optimizing care for children with ADHD.
  • Taiwan's National Health Insurance Research Database provides a valuable resource for studying healthcare utilization.

Purpose of the Study:

  • To investigate the patterns and predictors of rehabilitation resource utilization among children with and without ADHD in Taiwan.
  • To compare rehabilitation resource use between children diagnosed with ADHD and a non-ADHD control group.
  • To identify factors influencing the cost and frequency of rehabilitation services for pediatric ADHD.

Main Methods:

  • Retrospective cohort study using data from 2008-2012 from Taiwan's National Health Insurance Research Database.
  • Inclusion of children aged 3-12 years diagnosed with ADHD and a matched non-ADHD control group.
  • Statistical analyses included chi-squared tests, independent sample t-tests, and multiple regression analysis.

Main Results:

  • Children with ADHD demonstrated significantly higher utilization of rehabilitation resources compared to the non-ADHD group.
  • School-aged children had higher ADHD prevalence than preschool-aged children.
  • Clinics accounted for the highest rehabilitation resource utilization, particularly in Taipei, while the East region showed the lowest.
  • Rehabilitation use, costs, and frequency were influenced by demographic, hospital, and regional factors.
  • Clinic-based rehabilitation provided over 60% of services but incurred lower total annual costs than hospital-based care.

Conclusions:

  • Children with ADHD exhibit distinct patterns of rehabilitation resource utilization, with clinics playing a major role.
  • Healthcare policies should support early ADHD detection and treatment to improve outcomes and reduce long-term costs.
  • Addressing payment limitations and optimizing resource allocation between clinics and hospitals is necessary to enhance rehabilitation service accessibility and effectiveness.

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