Table 3 Study characteristics
Authous (Year) | Country | Study aim | Data source | Sample size (age) | Study perspective | Type of health services | Costs included in the study | Period of the study | ||
|---|---|---|---|---|---|---|---|---|---|---|
| Â | Â | Â | Â | Â | Â | Â | Average direct costs per person | Average indirect costs per person | Average total costs per person | Â |
Jarbrink and Knapp (2001) [23] | UK | To estimate the economic consequences of autism in the UK | Secondary analysis of data | Autism with additional learning disabilities | Patient Provider | Hospital/inpatient services Medication use Other | OOP: $67,098 Provider spending: $221,027 | NR | NR | Lifetime |
High functioning autism | OOP: NR Provider spending: $152,717 | $298,256 | NR | |||||||
Jarbrink (2003) [24] | USA | To show the major cost drivers among children with ASD | Survey (Respondents: parents) | N = 17 (4–10 years) | Provider | Early intervention Health services Medication use | Provider spending: $416 | NR | NR | Weekly |
Liptak et al. (2006) [25] | USA | To compare healthcare expenditures between children with ASD and other children with and without disabilities | Survey (Respondents: parents) | N = 100 (< 17 years old) | Patient | Home/community-based/outpatient services Hospital/inpatient services Medication use Respite care | OOP: $898 | NR | NR | Annual costs |
Flanders (2007) [26] | USA | To compare direct costs of treatment of children with ASD, asthma, and diabetes | Secondary analysis of data (California Medicaid Medical database) | N = 731 (3–17 years) | Payer | Hospital/inpatient services Outpatient services Medication use | Insurer spending: $6436 | NR | NR | Annual costs |
Jarbrink (2007) [27] | UK | To show the major cost drivers among children with ASD | Survey (Respondents: parents) | N = 55 (< 18 years old) | Provider | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | Provider spending: $3996 | NR | NR | Annual costs |
Leslie et al. (2007) [28] | USA | To examine the healthcare expenditures associated with ASDs in medical care settings | Secondary data analysis (Administrative claims database) | N = 613 (<  17 years old) | Payer Patient | Hospital/inpatient services Outpatient services Medication use | OOP + Insurer spending: $8531 | NR | NR | Annual costs |
Sharpe and Baker (2007) [29] | USA | To identify factors associated with financial problems in families that have a child with autism | Survey (Respondents: parents and care givers) | N = 333 (< 19 years old) | Patient | Hospital/inpatient services Outpatient services Respite care Medication use Other | NR | NR | NR | Annual costs |
Shimabukuro et al. (2008) [30] | USA | To estimate medical expenditures for children with ASD who receive employer-based health insurance | Secondary analysis of data (employer-based health insurance claims: the MarketScan research databases) | N = 3481 (1–21 years) | Payer Patient | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | OOP: $805 Insurer spending: $10,006 | NR | NR | Annual costs |
Knapp et al. (2009) [13] | UK | To estimate the costs of ASDs in the UK | Secondary analysis of data | Children with intellectual disability | Provider | Hospital/inpatient services Respite care Other | Provider spending: $11,946 | NR | NR | Annual costs |
Children without intellectual disability | Provider spending: $30,936 | NR | NR | |||||||
Young et al. (2009) [31] | USA | To examine the healthcare expenditures associated with ASDs in medical care settings. | Survey | N = 113 (2.5–21 years) | Patient | Hospital/inpatient services Outpatient services Respite care Medication use Other | OOP: $882 | NR | NR | Annual costs |
Wang et al. (2010) [32] | USA | To examine trends in health care expenditures associated with ASDs in state Medicaid programs | Secondary analysis of data (Medicaid data) | N = 69,542 (> 17 years old) | Payer | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | Insurer spending: $33,360 | NR | NR | Annual costs |
Barrett et al. (2012) [33] | UK | To determine family out-of-pocket expenses and productivity losses, and explore the relationship between family characteristics and costs. | Randomized controlled trial | N = 152 (2–4 years) | Patient Provider | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | OOP: $446 Provider spending: $2240 | $539 | $3792 | 6 months |
Parish et al. (2012) [34] | USA | To investigate the association between state Medicaid spending for children with disabilities and the financial burden reported by families of children with autism. | Secondary analysis of data (National Survey of Children with Special Healthcare Needs) | N = 2082 (<  18 years old) | Patients | NR | OOP: $690 | NR | NR | Annual costs |
Peacock et al. (2012) [10] | USA | To compare medical expenditures between children with ASDs and without ASDs | Secondary analysis of data (Health insurance claims: MarketScan Medicaid Multi-State Databases) | N = 8398 (2–17 years) | Payer | Hospital/inpatient services outpatient services Medication use | Insurer spending: $14,777 | NR | NR | Annual costs |
Wang et al. (2012) [35] | China | To determine the health expenses incurred by families of children with ASD and those expenses in relation to total patient income and expenditures | Survey (Respondents: parents) | N = 290 (1–15 years) | Patient | Home/community-based/outpatient services Respite care Medication use Other | OOP: $2936 | NR | NR | Annual costs |
Al-Farsi et al. (2013) [36] | Oman | To measure medical expenditures in children with ASDs | Survey (Respondents: parents) | N = 150 (< 15 years old) | Patient | Home/community-based/outpatient services Respite care Medication use Other | OOP:$346 | $961 | NR | Monthly |
Van Steensel et al. (2013) [37] | USA | To measure the societal costs of children with high-functioning ASD and comorbid anxiety disorder(s) | Survey (Respondents: parents) | N = 194 (7–18 years) | Patient | Home/community-based/outpatient services Respite care Medication use Other | OOP: $16,806 | NR | NR | Annual costs |
Raz et al. (2013) [38] | Israel | To measure the level of OOP expenditure for health services by families with autistic children | Survey (Respondents: parents) | N = 204 (4–10 years) | Patient | Home/community-based/outpatient services Respite care Medication use Other | OOP: $9930 | NR | NR | Annual costs |
Buescher et al. (2014) [9] | UK | To estimate lifetime societal economic costs among individuals with ASD | NR | NR | Patient | Medical services | Adults with ID: $8738 Adults without ID:$27,265 | NR | NR | Annual costs |
NR | Patient | Medical services | Children with ID:$1578 Children without ID: $1030 | NR | NR | Annual costs | ||||
USA | NR | Patient | Medical services | Adults with ID: $32,630 Adults without ID:$16,316 | NR | NR | Annual costs | |||
NR | Patient | Medical | Children with ID: $18,645 Children without ID: $9323 | NR | NR | Annual costs | ||||
Horlin et al. (2014) [14] | Australia | To compare expenses between families whose children receiving immediate versus delayed diagnoses | Survey (Respondents: parents) | N = 521 (< 18 years old) | Patient | All healthcare | OOP: $6937 | 30,422 (loss of income of the parents and caregivers) | 35,593 | Annual costs |
Lavelle et al. (2014) [12] | USA | To estimate the associations between ASD diagnoses and service use, caregiver time, and cost outcomes | Secondary analysis of data (National Health Interview Survey) and a study-specific survey | N = 258 (3–17 years old) | Patient Payer | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | Insurer spending: $3618 OOP: $218 | NR | NR | Annual costs |
Thomas et al. (2014) [39] | USA | To investigate the association between school transition age and healthcare expenditures for children with ASD | Secondary analysis of data (Pooled data from the Medical Expenditure Panel Survey) | N = 337 (<  21 years old) | Patient | All healthcare | Median OOP: $490 | NR | NR | Annual costs |
Barrett et al. (2015) [40] | UK | To describe the services and associated costs for individual with ASD and | Cohort of adolescents with ASD and other special needs | N = 51(adolescents with autistic disorder) (9–14 years) | Provider | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | Provider spending: $1231 | NR | NR | 6 months |
N = 45 (adolescents with other ASDs) (9–14 years) | Provider spending: $1999 | NR | NR | |||||||
Byford et al. (2015) [41] | UK | To investigate the cost-effectiveness of a communication-focused therapy for pre-school children with ASD | Cohort study | N = 77 (PACT+ treatment as usual) (2–4 years) | Provider Patient | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | OOP: $2896 Provider spending: $16,523 | $1223 | $20,645 | 13 months |
N = 75 (treatment as usual) (2–4 years) | Provider Patient | OOP: $1990 Provider spending: $5180 | $842 | $7923 | ||||||
Parish et al. (2015) [42] | USA | To investigate the relationship between family financial burden and children’s health | Secondary analysis of data (Pooled 2000–2009 Medical Expenditure Panel Survey data) | N = 316 (<  18 years old) | Patient | NR | OOP: $904 | NR | NR | Annual costs |
Thomas et al. (2016) [43] | USA | To examine expenditures according to types of health insurance included private alone, Medicaid alone, and combined private and wrap-around Medicaid | Secondary analysis of data (Pooled data from the Medical Expenditure Panel Survey) | N = 346 (< 18 years old) | Patient | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | OOP for Medicaid insured children: $156 OOP for private insured children: $1579 Medicaid spending: $8383 Private insurance spending: $3736 | NR | NR | Annual costs |
Barry et al. (2017) [44] | USA | To measure whether implementing autism mandates altered service use or spending among commercially insured children with ASD | Secondary analysis of data (Health insurance claim: Data from three national insurers) | N = 106,977 (< 21 years old) | Payer | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | Mandate eligible: $767 Mandate ineligible: $600 | NR | NR | Monthly |
Chang et al. (2018) [45] | Taiwan | To compare the differences in dental utilization and expenditure between children and adolescents with and without ASD | Secondary analysis of data (Health insurance claim: The database of the National Health Research Institutes) | N = 1305 (< 18 years old) | Payer | Dental treatment | Insurer spending: $110 | NR | NR | Annual costs |
Vohra et al. (2017) [46] | USA | To investigate the prevalence and association of comorbidities with healthcare utilization and expenditures of fee-for service enrolled adults with and without ASD | Secondary analysis of data (Health insurance claim: Medicaid data) | N = 1772 (22–64 years) | Payer | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | Insurer spending: $16,928 | NR | NR | Annual costs |
Candon et al. (2019) [47] | USA | To investigate whether mandates have heterogeneous effects on healthcare expenditure by insures and individuals with ASD | Secondary analysis of data (Health insurance claim) | N = 106,977 (< 21 years old) | Patient Payer | NR | OOP: $124 Insurer spending: $453 | NR | NR | Monthly |
Hong et al. (2019) [48] | South Korea | To estimate the economic burden of ASD in South Korea | Secondary analysis of data (Health insurance claim: The National Health Insurance Service) | N = 5653 (1–89 years) | Patient | Hospital/inpatient services Home/community-based/outpatient services | NR | NR | $2496 | Annual costs |
Li et al. (2019) [49] | Taiwan | To examine the cost and utilization of rehabilitation resources among children with ASD | Secondary analysis of data (Health insurance claim: The National Health Insurance Research Database) | N = 3227 (3–12 years) | Payer | Home/community-based/outpatient services | Insurer spending: $2100 | NR | NNRM | Annual costs |
Roddy and O’Neill (2019) [50] | Ireland | To measure the societal cost of childhood ASDs | Survey (Respondents: parents) | N = 222 (2–18 years) | Patient | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | OOP: $2756 | NR | NR | Annual costs |
Zerbo et al. (2019) [11] | USA | To compare healthcare utilization patterns and cost among insured adults with ASD, adults with ADHD and adults with neither condition | Secondary analysis of data (Administrative claim data: The Kaiser Permanente Northern California (KPNC) database | N = 1507 (> 18 years) | Provider | Hospital/inpatient services Home/community-based/outpatient services Respite care Other | Provider spending: $7889 | NR | NNRM | Annual costs |
Zuvekas et al. (2021) [51] | USA | To estimate healthcare costs for US children with ASD | Secondary analysis of data (Two different surveys) | N = 45,944 (3–17 years) | Patient | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | Medical Expenditure Panel Survey (MEPS: $4163 National Health Interview Survey (NHIS): $5955 | NR | NR | Annual costs |
Höfer et al. (2022) [52] | Germany | To estimate health service use and associated costs in children, adolescents and adults with ASD with and without intellectual disability | Survey (Respondents: parents) | N = 385 (4–67 years) | Patients | Hospital/inpatient services Home/community-based/outpatient services Respite care Other | $4208 | NR | NR | Annual costs |
Ames et al. (2021) [53] | USA | To calculate healthcare service utilization and cost among transition-age youth with ASD and other special healthcare needs | Secondary analysis of data (Administrative claim: Kaiser Permanente Northern California) | N = 4123 (14–25 years) | Provider | Hospital/inpatient services Home/community-based/outpatient services Respite care Medication use Other | Provider spending: $5302 | NR | NR | Annual costs |