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Health Care Costs and Utilization Rates for Children with Pervasive Developmental Disorders in North Dakota From 1998 to 2004: Impact on Medicaid

Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota

Preston Hatlestad, MD

Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota

Marilyn G. Klug, PhD

Center for Rural Health, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota

Jacob Kerbeshian, MD

Department of Neuroscience, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota

Larry Burd, PhD

Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Grand Forks, North Dakota, laburd{at}medicine.nodak.edu

In this study, we used data from the North Dakota Medicaid claims database from 1998 through 2004 to estimate health care utilization rates and cost of care for children with pervasive developmental disorders. From the dataset, we developed a group comprised of children with pervasive developmental disorders (n = 546) and 2 comparison groups: children with other mental disorders (n = 18 363) and children who did not have pervasive developmental disorders or any mental disorders (n = 63 202). Participants with pervasive developmental disorders utilized 4.6% of all visits and 5% of the total cost of health care over the 7-year period. The average annual cost of care for children with pervasive developmental disorders was much higher than the cost for children without mental disorders for outpatient services ($5051 vs $360, ratio = 14:1), inpatient services ($1585 vs $458, ratio = 3.4:1), and pharmacy services ($1258 vs $82, ratio = 15:1). Children with pervasive developmental disorders covered by Medicaid have increased costs of health care.

Key Words: autism • Medicaid • health care costs • comorbidity

Journal of Child Neurology, Vol. 24, No. 2, 140-147 (2009)
DOI: 10.1177/0883073808321059


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