Pediatric ADHD Accounts for 6 Million Physician Visits Annually

Pam Harrison

March 28, 2017

Children aged 4 to 17 years who have a primary diagnosis of attention-deficit/hyperactivity disorder (ADHD) collectively made 6.1 million visits to physicians' offices in 2012-2013, new research shows.

"Health care utilization related to ADHD is of interest because the prevalence of parent-reported ADHD diagnosis among US children and adolescents has increased in recent years," Michael Albert, MD, MPH, Hyattsville, Maryland, and colleagues write.

"Pediatricians (48%) and psychiatrists (36%) provided most of the care at ADHD visits...with 12% of the care being provided by general and family medicine physicians," they add.

The findings were published in a National Center for Health Statistics (NCHS) report for January.

Investigators evaluated the ADHD visit rate by age and sex and found that age had no effect on the visit rate. For children aged 4 to 12 years, there were 108 visits per 1000 children; for children aged 13 to 17, there were 99 visits per 1000 children.

In contrast, more than twice as many boys aged 4 to 17 years made an AHDH-related visit in 2012-2013, at 147 visits per 1000 boys, compared to 62 visits per 1000 girls.

This held true for the two age groups assessed, with boys aged 4 to 12 making 156 visits per 1000 boys vs 59 visits per 1000 girls. For children aged 13 to 17, boys made 130 visits per 1000 boys compared with 67 visits per 1000 girls.

During the visit, central nervous system (CNS) stimulants were provided, or were prescribed, or continued to be prescribed at virtually identical rates between the two age groups, at 80% for children aged 4 to 12 years and 81% for the older age group.

Methylphenidate or dexmethylphenidate was far more likely to be favored by physicians for the younger age group, at 48%, compared with 13% of an amphetamine-dextroamphetamine combination. In the older age group, methylphenidate or dexmethylphenidate was provided, prescribed, or continued to be prescribed in 46% of children vs 14% of those given an amphetamine-dextroamphetamine combination.

"No significant difference was observed in the mention of CNS stimulants for those aged 4-12 years compared with those aged 13-17 years," the researchers note.

An additional mental health disorder was diagnosed in 29% of all visits for ADHD.

These additional mental health disorders included episodic mood disorder, in 7% of the visits; anxiety, dissociative disorder, and somatoform disorder, in 7% of the visits; and disturbance of emotions specific to childhood and adolescence, in 4% of the visits.

Data for the NCHS brief were obtained from the National Ambulatory Medical Care Survey (NAMCS) for 2012-2013. The NAMCS is conducted each year by the NCHS. The authors have disclosed no relevant financial relationships.

NCHS. Data Brief No. 269. Full text

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