Skip to main content
SpringerLink
Log in

Medicaid Expenditures for Children with Autistic Spectrum Disorders: 1994 to 1999

  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

This study used data from 1994 to 1999 from one large county in Pennsylvania to estimate the Medicaid expenditures of children diagnosed with autism spectrum disorders (ASD) and to compare these expenditures with those of other Medicaid-eligible children. On average, children diagnosed with ASD had expenditures 10 times those of other children. Differences in expenditures were driven in large part by inpatient psychiatric care. Further research is required to determine whether hospitalized children could be served in less restrictive and less expensive settings. Lack of differences in ambulatory care expenditures suggests that children with ASD are not receiving additional primary care services that would be indicative of appropriately coordinated services as suggested by the medical home model.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1.
Fig. 2.

Similar content being viewed by others

References

  • Aman M., Lam K., Collier-Crespin A., (2003). Prevalence and patterns of use of psychoactive medicines among individuals with autism in the Autism Society of America Journal of Autism and Developmental Disorders 33(5): 527–533

    Article  PubMed  Google Scholar 

  • Aman M., Langworthy K., (2000). Pharmacotherapy for hyperactivity in children with autism and other pervasive developmental disorders Journal of Autism and Developmental Disorders 30(5): 451–459

    Article  PubMed  Google Scholar 

  • American Academy of Pediatrics (2001). The pediatrician’s role in the diagnosis and management of autistic spectrum disorder in children Pediatrics 107(5): 1221–1226

    Article  Google Scholar 

  • Barnard L., Young A., Pearson J., Geddes J., O’Brien G., (2002). A systematic review of the use of atypical antipsychotics in autism Journal of Psychopharmacology 16(1):93–101

    Article  PubMed  Google Scholar 

  • Birenbaum A., Guyot D., Cohen H., (1990). Health care financing for severe developmental disabilities Monographs of the American Association on Mental Retardation 14:1–150

    PubMed  Google Scholar 

  • Bonde E., (2000). Comorbidity and subgroups in childhood autism European Child and Adolescent Psychiatry 9:7–10

    Article  PubMed  Google Scholar 

  • Boyle C., Decoufle P., Yeargin-Allsopp M., (1994). Prevalence and health impact of developmental disabilities in US children Pediatrics 93:399–403

    PubMed  Google Scholar 

  • Braddock D., (2002). Disability at the dawn of the 21st century and the state of states. American Association on Mental Retardation, Washington, DC

    Google Scholar 

  • Bryson S., Rogers S., Fombonne E., (2003). Autism spectrum disorders: Early detection, intervention, education, and psychopharmacological management Canadian Journal of Psychiatry 48(8):506–516

    Google Scholar 

  • Bryson S., Smith I., (1998). Epidemiology of autism: Prevalence, associated characteristics, and implications for research and service delivery Mental Retardation and Developmental Disabilities Research Reviews 4:97–103

    Article  Google Scholar 

  • Committee on Children with Disabilities (2001). American Academy of Pediatrics: The pediatrician’s role in the diagnosis and management of autistic spectrum disorder in children. Pediatrics. 107(5): 1221–1226

    Article  Google Scholar 

  • Committee on Children with Disabilities (2001a). Role of the pediatrician in family-centered early intervention services Pediatrics 107(5):1155–1157

    Article  Google Scholar 

  • Committee on Children with Disabilities (2001b). Technical report: The pediatrician’s role in the diagnosis and management of autistic spectrum disorder in children Pediatrics 107(5):E85

    Article  Google Scholar 

  • Couris C. M., Rabilloud M., Colin C., Ecochard R., (2002). Two-phase study to assess the number of cases based on claims databases: Characteristics of the validation data set Methods of Information in Medicine 41(4):349–356

    PubMed  Google Scholar 

  • Dresser M. V. B., Feingold L., Rosenkranz S. L., Coltin K. L., (1997). Clinical quality measurement—Comparing chart review and automated methodologies Medical Care 35(6):539–552

    Article  PubMed  Google Scholar 

  • Eisenmajer R., Prior M., Leekam S., Wing L., Gould J., Welham M., Ong B., (1996). Comparison of clinical symptoms in autism and Asperger’s disorder Journal of the American Academy of Child and Adolescent Psychiatry 35(11):1523–1531

    Article  PubMed  Google Scholar 

  • Fombonne E., (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update Journal of Autism and Developmental Disorders 33(4):365–382

    Article  PubMed  Google Scholar 

  • Fujiura G. T., Roccoforte J. A., Braddock D., (1994). Costs of family care for adults with mental retardation and related developmental disabilities American Journal on Mental Retardation 99(3):250–261

    PubMed  Google Scholar 

  • Gallaher M., Christakis D., Connell F., (2002). Health care use by children diagnosed as having developmental delay Archives of Pediatrics and Adolescent Medicine 156(3):246–251

    PubMed  Google Scholar 

  • Gerlai J., Gerlai R., (2003). Autism: A large unmet medical need and a complex research problem Physiology and Behavior 79:461–470

    Article  PubMed  Google Scholar 

  • Guevara J., Mandell D., Rostain A., Zhao H., Hadley T., (2003). National estimates of health services expenditures for children with behavioral disorders: An analysis of the medical expenditure panel survey Pediatrics 112(6):e440–e446

    Article  PubMed  Google Scholar 

  • Hill A., Bolte S., Petrova G., Beltcheva D., Tacheva S., Poustka F., (2001). Stability and interpersonal agreement of the interview-based diagnosis of autism Psychopathology 34(4): 187–191

    Article  PubMed  Google Scholar 

  • Hughes J., Grayson R., Stiles F., (1977). Fragmentation of care and the medical home Pediatrics 60(4):559

    PubMed  Google Scholar 

  • Ireys H., Anderson G., Han C., Neff J., (1996). Cost of care for Medicaid-enrolled children with selected disabilities. US Department of Health and Human Services, Washington, DC

    Google Scholar 

  • Jacobson J., Mulick J., (2000). System and cost research issues in treatments for people with autistic disorders Journal of Autism & Developmental Disorders 30(6):585–593

    Article  Google Scholar 

  • Jacobson J., Mulick J., Green G., (1998). Cost-Benefit Estimates for Early Intensive Behavioral Intervention for Young Children With Autism- General Model and Single State Case Behavioral Interventions 13:201–226

    Article  Google Scholar 

  • Jarbrink K., Fombonne E., Knapp M., (2003). Measuring the Parental, Service and Cost Impacts of Children with Autistic Spectrum Disorder: A Pilot Study Journal of Autism & Developmental Disorders 33(4):395–402

    Article  Google Scholar 

  • Jarbrink K., Knapp M., (2001). The economic impact of autism in Britain Autism 5(1):7–22

    Article  PubMed  Google Scholar 

  • Jerrell J.. (1998). Utilization management analysis for children’s mental health services Journal of Behavioral Health Services & Research 25(1):35–42

    Article  Google Scholar 

  • Kashner T.M., (1998). Agreement between administrative files and written medical records-A case of the department of veterans affairs Medical Care 36(9):1324–1336

    Article  PubMed  Google Scholar 

  • Klabunde C.N., Potosky A.L., Legler J.M., Warren J.L., (2000). Development of a comorbidity index using physician claims data Journal of Clinical Epidemiology 53(12):1258–1267

    Article  PubMed  Google Scholar 

  • Krauss M., Gulley S., Sciegaj M., Wells N., (2003). Access to specialty medical care for children wtih mental retardation, autism and other special health care needs Mental Retardation 41(5):329–339

    Article  PubMed  Google Scholar 

  • Lurie N., Popkin M., Dysken M., Moscovice I., Finch M., (1992). Accuracy of diagnoses of schizophrenia in Medicaid claims Hospital & Community Psychiatry 43:69–71

    Google Scholar 

  • Mahoney W., Szatmari P., MacLean J., Bryson S., Bartolucci G., Walter S., Jones M., Zwaigenbaum L., (1998). Reliability and accuracy of differentiating pervasive developmental disorder subtypes Journal of the American Academy of Child & Adolescent Psychiatry 37(3):278–285

    Article  Google Scholar 

  • Mandell D., Listerud J., Levy S., Pinto-Martin J., (2002). Race Differences in the Age of Diagnosis among Medicaid-Eligible Children with Autism Journal of the American Academy of Child & Adolescent Psychiatry 41(12):1447–1453

    Article  Google Scholar 

  • Marcus L., Rubin J., Rubin M., (2000). Benefit-cost analysis and autism services: a response to Jacobson and Mulick Journal of Autism and Developmental Disorders 30:595–598

    Article  PubMed  Google Scholar 

  • Matson J., Benavidez D., Compton L., Paclawskyj T., Baglio C., (1996). Behavioral treatment of autistic persons: A review of research from 1980 to the present Research in Developmental Disabilities 17(6):433–465

    Article  PubMed  Google Scholar 

  • Medicode. (1987). International classification of diseases, 9 Med-Index Publications, Salt Lake City, UT

    Google Scholar 

  • Newschaffer C., Curran L., (2003). Autism: An emerging public health problem Public Health Reports 118(5):393–399

    PubMed  Google Scholar 

  • Rawson N. S. B., D’Arcy C., (1998). Assessing the validity of diagnostic information in administrative health care utilization data: Experience in Saskatchewan Pharmacoepidemiology and Drug Safety 7(6):389–398

    Article  PubMed  Google Scholar 

  • Rawson N. S. B., Malcolm E., (1995). Validity of the recording of ischaemic heart disease and chronic obstructive pulmonary disease in the Saskatchewan health care datafiles Statistics in Medicine 14(24):2627–2643

    Article  PubMed  Google Scholar 

  • Richdale A., (1999). Sleep problems in autism: Prevalence, cause, and intervention Developmental Medicine and Child Neurology 41(1):60–66

    Article  PubMed  Google Scholar 

  • Rinehart N., Bradshaw J., Brereton A., Tonge B., (2002). A clinical and neurobehavioural review of high-functioning autism and Asperger’s disorder Australian and New Zealand Journal of Psychiatry 36(6):762–770

    Article  PubMed  Google Scholar 

  • Romano P. S., (2000). Using administrative data to identify associations between implanted medical devices and chronic diseases Annals of Epidemiology 10(4):197–199

    Article  PubMed  Google Scholar 

  • Ryu S. Y., Park J. K., Suh I., Jee S. H., Park J., Kim C. B., Kim K. S., (2000). The accuracy of myocardial infarction diagnosis in medical insurance claims Yonsei Medical Journal 41(5):570–576

    PubMed  Google Scholar 

  • SAS Version 8.0 (2000). Cary, NC: The SAS Institute

  • Shatin D., Levin R., Ireys H., Haller V., (1998). Health care utilization by children with chronic illnesses: A comparison of Medicaid and employer-insured managed care Pediatrics 102(4):1–9

    Article  PubMed  Google Scholar 

  • Shatin D., Schech S. D., Patel K., McHutchison J. G., (2004). Population-based hepatitis C surveillance and treatment in a national managed care organization American Journal of Managed Care 10(4):250–256

    PubMed  Google Scholar 

  • Sia C., (1992). Abraham Jacobi Award address, April 14, 1992 the medical home: Pediatric practice and child advocacy in the 1990s Pediatrics 90(3):419–423

    PubMed  Google Scholar 

  • Sia, C., & Breakey, G. (1985). The role of the medical home in child abuse prevention and positive child development. Hawaii Medical Journal, 44(7), 242–244, 247

    Google Scholar 

  • Stein R., Silver E., (2003). Patterns of medical, educational and mental health service use in a national sample of US children Ambulatory Pediatrics 3(2):87–92

    Article  PubMed  Google Scholar 

  • US Department of Education (2003). Twenty-fifth annual report to congress on the implementation of the Individuals with Disabilities Education Act. Bureau of Special Education, Jessup, MD

    Google Scholar 

  • Volkmar F., Pauls D., (2003). Autism Lancet 362(9390):1133–1141

    Article  PubMed  Google Scholar 

  • Walkup J. T., Boyer C. A., Kellermann S. L., (2000). Reliability of medicaid claims files for use in psychiatric diagnoses and service delivery Administration and Policy in Mental Health 27(3):129–139

    Article  PubMed  Google Scholar 

  • Walsh K., Kastner T., Criscione T., (1997). Characteristics of hospitalizations for people with developmental disabilities: Utilization, costs, and impact of care coordination American Journal of Mental Retardation 101(5):505–520

    PubMed  Google Scholar 

  • Woods C. R., (2001). Impact of different definitions on estimates of accuracy of the diagnosis data in a clinical database Journal of Clinical Epidemiology 54(8):782–788

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by a Mentored Scientist Career Development Award (K01) from the National Institute of Mental Health (1 K01 MH067628).

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA

    David S. Mandell

  2. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania, USA

    David S. Mandell

  3. Department of Statistics, Temple University, Philadelphia, Pennsylvania, USA

    Jun Cao

  4. Division of Biostatistics, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA

    Richard Ittenbach

  5. University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA

    Jennifer Pinto-Martin

  6. Department of Psychiatry, Center for Mental Health Policy & Services Research, University of Pennsylvania Health System, 3535 Market Street – 3rd Floor, Philadelphia, PA, 19104-3309, USA

    David S. Mandell

Authors
  1. David S. Mandell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jun Cao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Richard Ittenbach
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jennifer Pinto-Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to David S. Mandell.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mandell, D., Cao, J., Ittenbach, R. et al. Medicaid Expenditures for Children with Autistic Spectrum Disorders: 1994 to 1999. J Autism Dev Disord 36, 475–485 (2006). https://doi.org/10.1007/s10803-006-0088-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-006-0088-z

Keywords

Search

Navigation