Comparing Uses and Expenses of Medical Care Services between Children with and without Attention-deficit/Hyperactivity Disorder

ADHD兒童與非ADHD兒童之醫療利用及費用之差異

10.29478/TJP.200912.0006

蔡忠志(Chong-Chih Tsai)；楊斯年(Szu-Nian Yang)；諶立中(Lih-Jong Shen)；張文瓊(Wen-Chiung Chang)；錢慶文(Ching-Wen Chien)

注意力不足過動症 ； 醫療利用 ； 醫療費用 ； ADHD ； medical expense ； medical use

台灣精神醫學

23卷4期（2009 / 12 / 01）

296 - 306

英文

目的：評估ADHD對醫療費用之影響，並探討造成費用差異的主要原因是否與治療ADHD有直接關係。方法：以2003-2006年台灣健保費用申報資料中，局別為配對條件選取對照組，比較兩組間醫療費用差異。並將ADHD組的醫療費用分為：一、直接用於治療ADHD；二、治療ADHD及其他共罹症；以及三、治療非ADHD的其他疾病等三類，以廣義估計方程式檢視在校正控制變項之後，罹患ADHD對第三類醫療費用之影響。结果：ADHD盛行率為0.55%，病例組平均年齡為9歲，男性佔81.23%，超過四成者有其他精神科合併症。病例組在各項醫療服務利用及費用上都顯著較高，校正其他控制變項之後，ADHD組的第三類各項醫療費用皆顯著高於對照組。结论：罹患ADHD的兒童在各項醫療服務利用及費用上都顯著的較高。ADHD組的醫療費用中以第三類佔絕大部分，代表ADHD兒童在其他的健康問題上的確還是有較高的醫療需求。伴隨ADHD的其他精神科合併症對其醫療利用有相當重要的影響力。

Objectives: This study was aimed at assessing the real differences in uses and expenses of medical care services between two groups of children with and without ADHD. Methods: Children aged between 6 and 15 years were chosen from 2003 to 2006 Inpatient and Outpatient Claim Database of Taiwan's National Health Insurance. Uses of medical care services and medical expenses were compared between children with and without ADHD. Medical expenses of the ADHD group were further divided into three use categories for (1) direct treatment of ADHD, (2) the treatment of ADHD and any other comorbidities, and (3) diseases not related to ADHD. The medical expenses were also compared between the third category of the ADHD group and the control group to assess their differences. Results: The prevalence of ADHD in our study was 0.55%. Average age of the ADHD group was nine years and 81.23% were males. Over 40% of all ADHD children were co-morbid with other psychiatric diseases/disorders. The ADHD group showed significantly higher use and expense in all medical services. ADHD had significantly positive impact on every expense in the third category. Conclusion: Children with ADHD used more medical resources and all the expenses were mostly spent on non-ADHD-related treatments. We suggest that children with ADHD need more medical supports for other health problems in addition to their own ADHD conditions, and that other ADHD comorbidities certainly have important impacts on the uses of the medical services.

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