Examining Health and Economic Outcomes Associated with Pediatric Medical Conditions in the United States

• Main Author: Lavelle, Tara
• Other Authors: Weinstein, Milton C.
• Language: en_US
• Published: Harvard University 2013
• Subjects: public health; health care management; economics
• Online Access: http://dissertations.umi.com/gsas.harvard:10450; http://nrs.harvard.edu/urn-3:HUL.InstRepos:10304401

The objective of this dissertation is to estimate the health and economic outcomes associated with two prominent child health conditions: autism spectrum disorder and influenza illness. Chapter 1 derives utility values associated with the health of children with autism spectrum disorder (ASD) and their parents. Our findings suggest that ASD has a large impact on the health-related quality of life of children and their caregivers, and that this impact is influenced by both the child’s specific diagnosis and the severity of their core social communication and repetitive behavior symptoms. Chapter 2 estimates the annual incremental costs associated with caring for a child with ASD from the societal perspective. Our findings suggest that there is a large economic burden both in terms of formal costs (healthcare, school and other direct costs of care) as well as the informal time costs of caregiving. Specifically, the societal costs of caring for this population amounted to $9.1 billion in 2011 alone, highlighting the tremendous financial challenges our society faces in meeting the needs of children with ASD. Chapter 3 uses a decision analytic model to evaluate 1-year clinical and economic outcomes associated with oseltamivir treatment for seasonal influenza in children, and considers the impact of oseltamivir resistance on these findings. Our results indicate that for unvaccinated children who present to their physician’s office with influenza-like symptoms, empiric antiviral treatment with oseltamivir appears to be a cost-effective treatment option. This is particularly true for ill children aged 1 to 12 years, but results are dependent on the prevalence of circulating seasonal influenza viruses that are resistant to oseltamivir.