Rates of Diagnosis of Neurodevelopmental Disorders Differ by Insurance Type

By Reuters Staff

January 07, 2022

NEW YORK (Reuters Health) - Children in the United States with Medicaid insurance are more apt to be diagnosed with attention-deficit/hyperactivity disorder (ADHD), autism or other neurodevelopmental disorders than peers with private insurance.

Among more than 3.3 million children, by age 8 years, roughly one in four (23.9%) publicly insured children and one in nine (11.0%) privately insured children had received a diagnosis of one or more neurodevelopmental disorders (NDDs), researchers found.

Just over 1% of children in both insurance groups were diagnosed with autism spectrum disorder by age 8 years.

Yet 14.5% of those covered under Medicaid had ADHD compared with 5.8% of those on private insurance, Dr. Loreen Straub of Brigham and Women's Hospital in Boston and colleagues report in JAMA Psychiatry.

Rates of diagnosed speech or language disorder were 8.4% in those with public insurance versus 4.5% in those privately insured; rates of diagnosed behavioral disorder were 8.4% and 1.5%, respectively.

Regardless of insurance type, rates of at least one diagnosed NDD were considerably higher among boys and among white children. Except for ADHD, the diagnosis of NDD tended to be made somewhat earlier for privately insured children.

Co-occurring NDD diagnoses were common and higher in publicly than privately insured children (23.0% vs. 17.9%).

"NDDs are an important public health concern, and studies assessing risk factors at the population level are needed to help identify opportunities for prevention, early diagnosis, and intervention," the authors say.

"The high incidence of NDDs, coupled with racial and socio-demographic disparities, underscores the importance of raising awareness of providing universal and timely access to psychological and educational services to ensure that diagnosis, intervention and support can start as soon as possible for all children with NDDs, with the goal of preventing and/or mitigating long-term developmental deficits and economic or other burdens on the family and society," they conclude.

This study was supported by a grant from the National Institute of Mental Health. Dr. Straub has no relevant disclosures.

SOURCE: https://bit.ly/3pTmMwF JAMA Psychiatry, online January 5, 2022.