TY - JOUR
T1 - Emergency department use and costs for youth with attention-deficit/hyperactivity disorder
T2 - Associations with stimulant treatment
AU - Leibson, Cynthia L.
AU - Barbaresi, William J.
AU - Ransom, Jeanine
AU - Colligan, Robert C.
AU - Kemner, Jason
AU - Weaver, Amy L.
AU - Katusic, Slavica K.
N1 - Funding Information:
The project was supported by research grants from the Public Health Service, National Institutes of Health (HD29745 and AR30582) and by an investigator-initiated research grant from McNeil Consumer & Specialty Pharmaceuticals. We acknowledge the contributions of Diane Siems, the study coordinator, and Candice Klein and Jeaneen Alcorn, data abstractors. We thank Karen Tennison for assistance with manuscript preparation. We also thank individuals involved with ISD 535 for their cooperation and collaboration.
PY - 2006
Y1 - 2006
N2 - Objective.- To investigate whether, among youth with attention-deficit/hyperactivity disorder (ADHD), stimulant treatment is associated with reduced emergency department (ED) use and medical costs. Methods.- We previously reviewed the complete and detailed school and medical records of all individuals born 1976-1982 in Rochester, Minn, to identify those who met criteria for ADHD between age 5 years and emigration from the area. Stimulant treatment (all start/stop dates, dosages) was also abstracted. This study followed birth cohort members with ADHD in provider-linked billing data from January 1, 1987 (billing data first available), to age 18 for outcomes: ED visits, ED costs, and medical costs. For each outcome, we analyzed associations with 1) any stimulants (yes/no), 2) proportion of follow-up time on stimulants, and 3) among those treated with stimulants, periods on versus off stimulants. Results.- Of 313 youth with ADHD, 231 (74%) received any stimulants; treatment duration ranged from 14 days to 11.8 years. Treated and untreated youth were similar with respect to median annual ED visits (0.5 vs 0.5) and medical costs ($661 vs $741) (P > .05); however, increasing proportion of follow-up on stimulants was associated with fewer ED visits (P= .02) and higher medical costs (P< .001). The 231 treated youth experienced an average of 3.7 periods on and off stimulants; while receiving stimulants, they exhibited fewer ED visits (P= .02), lower ED costs (P = .03), and higher medical costs (P< .001) compared with periods off stimulants. Conclusions.- Among youth with ADH D, extended stimulant treatment is associated with decreased ED visits and ED costs, but higher total medical costs.
AB - Objective.- To investigate whether, among youth with attention-deficit/hyperactivity disorder (ADHD), stimulant treatment is associated with reduced emergency department (ED) use and medical costs. Methods.- We previously reviewed the complete and detailed school and medical records of all individuals born 1976-1982 in Rochester, Minn, to identify those who met criteria for ADHD between age 5 years and emigration from the area. Stimulant treatment (all start/stop dates, dosages) was also abstracted. This study followed birth cohort members with ADHD in provider-linked billing data from January 1, 1987 (billing data first available), to age 18 for outcomes: ED visits, ED costs, and medical costs. For each outcome, we analyzed associations with 1) any stimulants (yes/no), 2) proportion of follow-up time on stimulants, and 3) among those treated with stimulants, periods on versus off stimulants. Results.- Of 313 youth with ADHD, 231 (74%) received any stimulants; treatment duration ranged from 14 days to 11.8 years. Treated and untreated youth were similar with respect to median annual ED visits (0.5 vs 0.5) and medical costs ($661 vs $741) (P > .05); however, increasing proportion of follow-up on stimulants was associated with fewer ED visits (P= .02) and higher medical costs (P< .001). The 231 treated youth experienced an average of 3.7 periods on and off stimulants; while receiving stimulants, they exhibited fewer ED visits (P= .02), lower ED costs (P = .03), and higher medical costs (P< .001) compared with periods off stimulants. Conclusions.- Among youth with ADH D, extended stimulant treatment is associated with decreased ED visits and ED costs, but higher total medical costs.
KW - Attention-deficit/hyperactivity disorder
KW - Emergency department
KW - Stimulant treatment
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U2 - 10.1016/j.ambp.2005.08.005
DO - 10.1016/j.ambp.2005.08.005
M3 - Article
C2 - 16443183
AN - SCOPUS:33644508348
SN - 1530-1567
VL - 6
SP - 45
EP - 53
JO - Ambulatory Pediatrics
JF - Ambulatory Pediatrics
IS - 1
ER -