Health care and societal costs of the management of children and adolescents with attention-deficit/hyperactivity disorder in Spain: a descriptive analysis.
Por:
Quintero J, Ramos-Quiroga JA, Sebastián JS, Montañés F, Fernández-Jaén A, Martínez-Raga J, Giral MG, Graell M, Mardomingo MJ, Soutullo C, Eiris J, Téllez M, Pamias M, Correas J, Sabaté J, García-Orti L and Alda JA
Publicada:
8 feb 2018
Ahead of Print:
8 feb 2018
Categoría:
Psychiatry and mental health
Resumen:
BACKGROUND: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental condition in childhood (5.3% to 7.1% worldwide prevalence), with substantial overall financial burden to children/adolescents, their families, and society. The aims of this study were to describe the clinical characteristics of children and adolescents with ADHD in Spain, estimate the associated direct/indirect costs of the disorder, and assess whether the characteristics and financial costs differed between children/adolescents adequately responding to currently available pharmacotherapies compared with children/adolescents for whom pharmacotherapies failed. METHODS: This was a multicenter, cross-sectional, descriptive analysis conducted in 15 health units representative of the overall Spanish population. Data on demographic characteristics, socio-occupational status, social relationships, clinical variables of the disease, and pharmacological and non-pharmacological treatments received were collected in 321 children and adolescents with ADHD. Direct and indirect costs were estimated over one year from both a health care system and a societal perspective. RESULTS: The estimated average cost of ADHD per year per child/adolescent was €5733 in 2012 prices; direct costs accounted for 60.2% of the total costs (€3450). Support from a psychologist/educational psychologist represented 45.2% of direct costs and 27.2% of total costs. Pharmacotherapy accounted for 25.8% of direct costs and 15.5% of total costs. Among indirect costs (€2283), 65.2% was due to caregiver expenses. The total annual costs were significantly higher for children/adolescents who responded poorly to pharmacological treatment (€7654 versus €5517; P = 0.024), the difference being mainly due to significantly higher direct costs, particularly with larger expenses for non-pharmacological treatment (P = 0.012). CONCLUSIONS: ADHD has a significant personal, familial, and financial impact on the Spanish health system and society. Successful pharmacological intervention was associated with lower overall expenses in the management of the disorder.
Filiaciones:
Quintero J:
Psychiatry Department, Hospital Universitario Infanta Leonor and Psychiatry and Medical Psychology Department, Complutense University, Madrid, Spain
Ramos-Quiroga JA:
Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
and Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Bellaterra, Spain
Sebastián JS:
Child and Adolescent Psychiatry Department, Hospital Universitario Ramón y Cajal, Madrid, Spain and Psychiatry Department, Universidad de Alcalá, Madrid, Spain
Montañés F:
Hospital Universitario Fundación de Alcorcón, Madrid, Spain and Rey Juan Carlos I University, Madrid, Spain
Fernández-Jaén A:
Department of Neuropediatrics, Hospital Universitario Quirón, Madrid, Spain
Martínez-Raga J:
UDPyPC, Hospital Universitario Dr. Peset and University of Valencia and University CEU-UCH, Valencia, Spain
Giral MG:
Child and Adolescent Psychiatry and Psychology Department, Institute of Neuroscience, Hospital Clinic, Barcelona, Spain
Graell M:
Child and Adolescent Psychiatry and Psychology Department, Hospital Infantil Universitario Niño Jesús and Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
Mardomingo MJ:
Child and Adolescent Psychiatry Department, Hospital Gregorio Marañón, Universidad Complutense, Madrid, Spain
Soutullo C:
Child and Adolescent Psychiatry Unit, Department of Psychiatry and Medical Psychology, University of Navarra Clinic, Pamplona, Spain
Eiris J:
Neuropediatric Division, Pediatric Department, Complejo Hospitalario Universitario Santiago De Compostela, Santiago de Compostela, Spain
Téllez M:
Department of Neuropediatrics, Hospital La Fe, Valencia, Spain
Pamias M:
Hospital Parc Taulí, Sabadell, Spain and Autonomous University of Barcelona, Bellaterra, Spain
Correas J:
Psychiatry and Mental Health Department, Hospital Universitario del Henares, Francisco de Victoria University, Madrid, Spain
Sabaté J:
Shire, Madrid, Spain
García-Orti L:
Shire, Madrid, Spain
Alda JA:
Child and Adolescent Psychiatry and Psychology Department, Hospital Sant Joan de Déu, Esplugues de Llobregat, 08950, Barcelona, Spain.
Open Access
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