Societal costs and quality of life of children suffering from attention deficient hyperactivity disorder (ADHD).
BACKGROUND
The impact of attention deficit hyperactive disorder (ADHD) in the Netherlands on health care utilisation, costs and quality of life of these children, as well as of their parents is unknown.


OBJECTIVE
The aim of this study was to assess the direct medical costs of patients suffering from ADHD and their quality of life as well as the direct medical costs of their mothers.


METHODS
We selected a group of 70 children who were being treated by a paediatrician for ADHD based on the DSM-IV diagnostic criteria for ADHD. For comparison's sake, we also included a non-matched group of 35 children with behaviour problems and 60 children with no behaviour problem from a large school population-based study on the detection of ADHD. We collected information on the health care utilisation of the children applying the Trimbos and iMTA questionnaire on Costs associated with Psychiatric illness' (TiC-P). Their health related quality of life was collected by using the Dutch 50-item parent version of the Child Health Questionnaire (CHQ PF-50). Measurements were at baseline and at 6 months. Subsequently, we collected data on the health utilisation of the mothers and their production losses due to absence from work and reduced efficiency.


RESULTS
The mean direct medical costs per ADHD patient per year were euro 2040 or euro 1173 when leaving out one patient with a long-term hospital admission, compared to euro 288 for the group of children with behaviour problems and euro 177 for the group of children with no behaviour problems. The direct medical costs for children who had psychiatric co-morbidities were significantly higher compared to children with ADHD alone. The mean medical costs per year for the mothers of the ADHD patients were significantly higher than for the mothers of the children with behaviour problems and the mothers of children with no behaviour problems respectively euro 728, euro 202 and euro 154. The physical summary score showed no significant differences between the groups. However, the score on the Psychosocial Summary Score dimension was significantly lower for ADHD patients compared to the scores of the children in the two other samples. The mean annual indirect costs due to absence from work and reduced efficiency at work were euro 2243 for the mothers of the ADHD patients compared to euro 408 for the mothers of children with behaviour problems and euro 674 for the mothers of children with no behaviour problems.


CONCLUSIONS
Our study showed that the direct medical costs of ADHD patients were relatively high. Additionally, our study indicated that ADHD appears to be accompanied by higher (mental) health care costs for the mothers of ADHD patients and by increased indirect costs for this group.
Hakkaart-van Roijen
L
L
Institute for Medical Technology Assessment (iMTA), Erasmus MC, P.O. Box 1738, 3000, Rotterdam, DR, The Netherlands. l.hakkaart-vanroijen@erasmusmc.nl
Zwirs
B W C
BW
Bouwmans
C
C
Tan
S S
SS
Schulpen
T W J
TW
Vlasveld
L
L
Buitelaar
J K
JK
D001289:Attention Deficit Disorder with Hyperactivity / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D002648:Child; D017281:Cost of Illness; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D017048:Health Care Costs; D006296:Health Services / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires