title: Treatment use and costs among privately insured youths with diagnoses of bipolar disorder.
abstract: OBJECTIVE
  Recent evidence suggests that children are increasingly diagnosed as having bipolar disorder, yet no studies have quantified treatment costs for pediatric patients. The objectives of the study were to identify one-year health services utilization and treatment costs among youths newly diagnosed as having bipolar disorder.
  
  
  METHODS
  MarketScan administrative claims from 2005 to 2007 were used to construct a retrospective person-level cohort of children ages zero to 17 to identify one-year health services utilization and costs among privately insured youths with a bipolar diagnosis. Inpatient and outpatient services were categorized as mental health related or non–mental health related. Pharmacy costs were classified as psychotropic or nonpsychotropic.
  
  
  RESULTS
  In the sample (4,973 youths), one-year mean reimbursements for health services were $10,372, and patient out-of-pocket spending was $1,429 per child. Mental health services accounted for 71% of all health care spending, with psychotropic medications and inpatient care contributing the largest proportions of total spending (24% and 27%, respectively) .
  
  
  CONCLUSIONS
  The costs of care among privately insured children with bipolar disorder are similar to those of adults. However, spending on children is concentrated on mental health–related services. Because private insurance plans have historically limited mental health service benefits, the concentration of spending on mental health services may place a greater burden on families for out-of-pocket payments. As mental health parity is adopted by private insurers, monitoring its impact on patient utilization and costs of health services will be important, particularly for children with serious mental illness.
authors.affiliation: Department of Health Care Policy, Harvard Medical School, 180 Longwood Ave., Boston, MA 02115, USA. dusetzina@hcp.med.harvard.edu
authors.forename: Stacie B
authors.initials: SB
authors.lastname: Dusetzina
authors.forename: Joel F
authors.initials: JF
authors.lastname: Farley
authors.forename: Morris
authors.initials: M
authors.lastname: Weinberger
authors.forename: Bradley N
authors.initials: BN
authors.lastname: Gaynes
authors.forename: Betsy
authors.initials: B
authors.lastname: Sleath
authors.forename: Richard A
authors.initials: RA
authors.lastname: Hansen
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data; D001714:Bipolar Disorder / Q000191:economics / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics; D008297:Male; D008605:Mental Health Services / Q000191:economics / Q000706:statistics & numerical data; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use; D012189:Retrospective Studies; D014481:United States
chemical_list: D011619:Psychotropic Drugs