Abstract
The study aimed to investigate the economic costs in families of children with autism spectrum disorder (ASD) and explored how the time interval from diagnosis to treatment time interval from the date children first diagnosed with ASD to the date of first speech/behavior treatment influenced the economic costs. It was a cross-sectional study that recruited families with autistic children in Changsha, Hunan Province of China during March to November 2018. A self-designed questionnaire was applied to collect ASD-related economic costs in the two vital periods including the 12-month period after diagnosis and the most recent 12 months during the course of ASD. In total, 136 families with autistic children completed the interview. The results showed that 46.3% of children started intervention within 1 month. The median of total economic costs of these families in the 12-month period after diagnosis and the most recent 12 months was 26,502.26 RMB and 29,411.91 RMB, respectively. Compared with the time interval shorter than 1 month, time interval over 6 months was significantly associated with high direct economic costs (βSD = 0.308, 95% CI = 0.177, 1.254), inpatient/outpatient and drugs costs (βSD = 0.276, 95% CI = 0.104, 1.181), direct non-medical costs (βSD = 0.287, 95% CI = 0.140, 1.206), and total economic burden (βSD = 0.311, 95% CI = 0.186, 1.262); besides, time interval between 4 and 6 months was significantly related to large indirect costs (βSD = 0.230, 95% CI = 0.098, 1.363) in the 12-month period after diagnosis. Similarly, time interval between 1 and 3 months was significantly associated with high direct non-medical costs (βSD = 0.198, 95% CI = 0.004, 1.013) in the 12-month period after diagnosis. However, time interval from diagnosis to treatment was not correlated to economic costs in the recent 12 months. In the long term, shortening the time interval from diagnosis to treatment would reduce the economic burden on families, especially in the 12-month period after diagnosis.
Highlights
Autism spectrum disorder (ASD) is a highly heterogeneous group of neurodevelopmental disorders characterized by different levels of impairment in social communication and interaction, repetitive behaviors, and restricted language ability [1]
Autistic children were strictly defined as having an autistic disorder based on DSM-IV, while children with a pervasive developmental disorder not otherwise specified (PDD-NOS) or with Asperger syndrome were excluded from the study
Seventy families (51.5%) reported that in the past 12 months, ASD-related treatment costs had accounted for 25–50% of the total family income
Summary
Autism spectrum disorder (ASD) is a highly heterogeneous group of neurodevelopmental disorders characterized by different levels of impairment in social communication and interaction, repetitive behaviors, and restricted language ability [1]. An increasing prevalence of ASD has been reported worldwide regardless of ethnic or cultural background [2,3,4]. A meta-analysis study indicated that the pooled prevalence of ASD in mainland China was 3.92‰ [5]. The long-term prognosis of most individuals with ASD is poor, namely, they lack the ability to study and work independently in adulthood [7]. These patients have to rely on parental care for extended periods and need long-term rehabilitation, which probably leads to heavy economic burden to families and society [8, 9]
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