Health Services Use and Costs in Individuals with Autism Spectrum Disorder in Germany: Results from a Survey in ASD Outpatient Clinics.
Juliana Höfer, Falk Hoffmann, Michael Dörks and 8 others
PMID 33728496WHAT IT FOUND
German ASD outpatient clinic patients averaged 3287 EUR in yearly health service costs.
Occupational therapy was the most used non-doctor service. Higher costs were seen with female sex, lower IQ, and Asperger syndrome.
Key findings
01The average annual health service cost per person with ASD was 3287 EUR.
02Occupational therapy was the leading non-physician practitioner service overall, used by 22.8% of participants, and it accounted for 11.1% of total costs.
03Higher costs were associated with female sex, lower IQ, and Asperger syndrome, but not with ADOS comparison score.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for SLPs
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What it does not show
Only 385 of the 418 returned questionnaires could be evaluated, and the response rate was 32.3%, so many invited patients are not represented. Responders and non-responders differed in ASD subgroups, with more Asperger syndrome among responders. Participants came from four large German ASD outpatient clinics, not the general population, so results may not apply to undiagnosed or community settings. The study did not record co-occurring conditions, adaptive functioning, or socioeconomic status, which can affect service use and costs. Costs relied on recall over the previous 12 months and extrapolated 4-week medication data to a year. Interventions funded by social services for core ASD symptoms were excluded, so total societal cost is not captured. The authors state the higher costs for females need replication in a larger sample. The study reports service use and costs, not patient outcomes or treatment effectiveness.
Declared interests
Funding was named from Bundesministerium für Bildung und Forschung and Universitätsklinikum Ulm. The supplied text does not report an author conflict-of-interest declaration.
The easy way to misread this
Do not read the high occupational therapy use and cost as evidence that occupational therapy improves ASD outcomes. The study recorded service contacts and costs only, and it did not compare treated and untreated patients or measure patient outcomes.