Child health costs similar for behavioral compared to physical disorders

May 05, 2003

Children with behavioral disorders incur similar overall health care costs to children with physical disorders. Among behavioral disorders, costs were not uniform; anxiety and depression cost twice as much as other common behavioral disorders, mainly as a result of inpatient hospitalizations.

Researchers from The Children's Hospital of Philadelphia and the University of Pennsylvania presented their results today at the Pediatric Academic Societies meeting in Seattle.

"Examining healthcare costs, for children especially, is an increasingly important issue," said James P. Guevara, M.D., general pediatrician at The Children's Hospital of Philadelphia and primary investigator of this study. "This study shows that children with behavioral disorders incur similar healthcare costs to those with physical disorders, a recent observation which is important knowledge for the healthcare industry."

The retrospective cohort study looked at children ranging in age from 2 to 18 years old whose families participated in the 1996 Medical Expenditure Panel Survey. Children with common behavioral disorders were identified using diagnostic codes determined from household interviews. Researchers compared them to two control groups - healthy children and children with common physical disorders such as asthma, epilepsy and diabetes.

Among the 3,955 eligible children, almost seven percent were identified with a behavioral disorder, including attention-deficit/hyperactivity disorder (ADHD), depression, anxiety, conduct disorder and oppositional-defiant disorder. Children with behavioral disorders incurred greater overall expenditures than healthy children ($1468 vs. $710), but costs were similar to those of children with physical disorders ($1468 vs. $1071).

Children with behavioral disorders incurred greater expenditures for office-based visits and prescription medications than children in either control group. Among children with behavioral disorders, children with depression and anxiety had double the overall expenditures as children with disruptive disorders - those that are apparent to others - such as attention-deficit/hyperactivity disorder (ADHD), conduct and oppositional-defiant disorders. This was mainly a result of increased hospitalization expenditures.

Study co-authors were Anthony L. Rostain, M.D., and Huaqing Zhao from The Children's Hospital of Philadelphia, and David S. Mandell, Sc.D., and Trevor R. Hadley, Ph.D. of the University of Pennsylvania.

"Further study to determine reasons for higher hospitalization costs among children with depression and anxiety is needed," said Guevara.
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Founded in 1855 as the nation's first pediatric hospital, The Children's Hospital of Philadelphia is ranked today as the best pediatric hospital in the nation by a comprehensive Child magazine survey. Its pediatric research program is among the largest in the country, ranking second in National Institutes of Health funding. Children's Hospital operates the largest pediatric healthcare system in the U.S. with more than 40 locations in Pennsylvania, New Jersey and Delaware.

Children's Hospital of Philadelphia

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