Health Services Use and Costs in Individuals with Autism Spectrum Disorder in Germany: Results from a Survey in ASD Outpatient Clinics

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Abstract

Autism spectrum disorders (ASD) are associated with high services use, but European data on costs are scarce. Utilisation and annual costs of 385 individuals with ASD (aged 4–67 years; 18.2% females; 37.4% IQ < 85) from German outpatient clinics were assessed. Average annual costs per person were 3287 EUR, with psychiatric inpatient care (19.8%), pharmacotherapy (11.1%), and occupational therapy (11.1%) being the largest cost components. Females incurred higher costs than males (4864 EUR vs. 2936 EUR). In a regression model, female sex (Cost Ratio: 1.65), lower IQ (1.90), and Asperger syndrome (1.54) were associated with higher costs. In conclusion, ASD-related health costs are comparable to those of schizophrenia, thus underlining its public health relevance. Higher costs in females demand further research.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10803-021-04955-4.

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Most cited references 44

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Autism spectrum disorder

Catherine Lord, Traolach S Brugha, Tony Charman … (2020)

Autism spectrum disorder is a construct used to describe individuals with a specific combination of impairments in social communication and repetitive behaviours, highly restricted interests and/or sensory behaviours beginning early in life. The worldwide prevalence of autism is just under 1%, but estimates are higher in high-income countries. Although gross brain pathology is not characteristic of autism, subtle anatomical and functional differences have been observed in post-mortem, neuroimaging and electrophysiological studies. Initially, it was hoped that accurate measurement of behavioural phenotypes would lead to specific genetic subtypes, but genetic findings have mainly applied to heterogeneous groups that are not specific to autism. Psychosocial interventions in children can improve specific behaviours, such as joint attention, language and social engagement, that may affect further development and could reduce symptom severity. However, further research is necessary to identify the long-term needs of people with autism, and treatments and the mechanisms behind them that could result in improved independence and quality of life over time. Families are often the major source of support for people with autism throughout much of life and need to be considered, along with the perspectives of autistic individuals, in both research and practice.

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Premature mortality in autism spectrum disorder.

Tatja Hirvikoski, Ellenor Mittendorfer-Rutz, Marcus Boman … (2016)

Mortality has been suggested to be increased in autism spectrum disorder (ASD).

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Costs of autism spectrum disorders in the United Kingdom and the United States.

Ariane Buescher, Zuleyha Cidav, Martin Knapp … (2014)

The economic effect of autism spectrum disorders (ASDs) on individuals with the disorder, their families, and society as a whole is poorly understood and has not been updated in light of recent findings.

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Author and article information

Contributors

Christian J. Bachmann: christian.bachmann@uniklinik-ulm.de

Journal

Journal ID (nlm-ta): J Autism Dev Disord

Journal ID (iso-abbrev): J Autism Dev Disord

Title: Journal of Autism and Developmental Disorders

Publisher: Springer US (New York )

ISSN (Print): 0162-3257

ISSN (Electronic): 1573-3432

Publication date (Electronic): 17 March 2021

Publication date PMC-release: 17 March 2021

Publication date (Print): 2022

Volume: 52

Issue: 2

Pages: 540-552

Affiliations

[1 ]GRID grid.5560.6, ISNI 0000 0001 1009 3608, Department of Health Services Research, , Carl von Ossietzky University Oldenburg, ; Oldenburg, Germany

[2 ]GRID grid.10253.35, ISNI 0000 0004 1936 9756, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, , Philipps University Marburg, ; Marburg, Germany

[3 ]GRID grid.6363.0, ISNI 0000 0001 2218 4662, Department of Psychiatry, Campus Benjamin Franklin, , Charité - Universitätsmedizin Berlin, ; Berlin, Germany

[4 ]GRID grid.7468.d, ISNI 0000 0001 2248 7639, Present Address: Department of Psychology, , Humboldt-Universität zu Berlin, ; Berlin, Germany

[5 ]GRID grid.411984.1, ISNI 0000 0001 0482 5331, Present Address: Department of Child and Adolescent Psychiatry, , University Medical Center Göttingen, ; Göttingen, Germany

[6 ]GRID grid.4488.0, ISNI 0000 0001 2111 7257, Department of Child and Adolescent Psychiatry, , Medical Faculty of the Technical University Dresden, ; Dresden, Germany

[7 ]GRID grid.6582.9, ISNI 0000 0004 1936 9748, Department of Child and Adolescent Psychiatry, , University of Ulm, ; Ulm, Germany

[8 ]GRID grid.7700.0, ISNI 0000 0001 2190 4373, Department of Child and Adolescent Psychiatry and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health, , Heidelberg University, ; Mannheim, Germany

[9 ]GRID grid.22937.3d, ISNI 0000 0000 9259 8492, Department of Child and Adolescent Psychiatry, , Medical University of Vienna, ; Vienna, Austria

Article

Publisher ID: 4955

DOI: 10.1007/s10803-021-04955-4

PMC ID: 8813793

PubMed ID: 33728496

SO-VID: c0f35d55-7593-4468-a430-1a53f30dafc7

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date accepted : 1 March 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100002347, Bundesministerium für Bildung und Forschung;

Award ID: 01EE1409F

Award Recipient : Falk Hoffmann

Funded by: Universitätsklinikum Ulm (8941)

Open Access :

Open Access funding enabled and organized by Projekt DEAL.

Custom metadata

ScienceOpen disciplines: Neurology

Keywords: adolescents,adults,children,costs,germany,health services

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ScienceOpen disciplines: Neurology

Keywords: adolescents, adults, children, costs, germany, health services

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Health Services Use and Costs in Individuals with Autism Spectrum Disorder in Germany: Results from a Survey in ASD Outpatient Clinics

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Karger: Neurology and Neuroscience

Most cited references 44

Autism spectrum disorder

Premature mortality in autism spectrum disorder.

Costs of autism spectrum disorders in the United Kingdom and the United States.

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