24515505
OBJECTIVE	To estimate the associations between autism spectrum disorder ( ASD ) diagnoses and service use , caregiver time , and cost outcomes .
METHODS	We used national data from the Medical Expenditure Panel Survey linked to the National Health Interview Survey and a study-specific survey to estimate the annual utilization and costs for health care , school , ASD-related therapy , family-coordinated services , as well as caregiver time in children aged 3 to 17 years , with and without parent-reported ASD .
METHODS	Regression analyses estimated the association between ASD diagnosis and cost , controlling for child gender , age , race/ethnicity , insurance status , household income , country region and urban/rural classification , and non-ASD-related illnesses .
RESULTS	Children with parent-reported ASD had higher levels of health care office visits and prescription drug use compared with children without ASD ( P < .05 ) .
RESULTS	A greater proportion of children in the ASD group used special educational services ( 76 % vs. 7 % in the control group , P < .05 ) .
RESULTS	After adjusting for child demographic characteristics and non-ASD-associated illnesses , ASD was associated with $ 3020 ( 95 % confidence interval [ CI ] : $ 1017 - $ 4259 ) higher health care costs and $ 14,061 ( 95 % CI : $ 4390 - $ 24,302 ) higher aggregate non-health care costs , including $ 8610 ( 95 % CI : $ 6595 - $ 10,421 ) higher school costs .
RESULTS	In adjusted analyses , parents who reported that their child had ASD did not have significantly higher out-of-pocket costs or spend more time on caregiving activities compared with control parents .
CONCLUSIONS	The economic burden associated with ASD is substantial and can be measured across multiple sectors of our society .
CONCLUSIONS	Previous analyses that focused on health care underestimated this economic burden , particularly for school systems .

