Emergency department use and costs for youth with attention-deficit/hyperactivity disorder: Associations with stimulant treatment

Cynthia L. Leibson, William J. Barbaresi, Jeanine Ransom, Robert C. Colligan, Jason Kemner, Amy L. Weaver, Slavica K. Katusic

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


Objective.- To investigate whether, among youth with attention-deficit/hyperactivity disorder (ADHD), stimulant treatment is associated with reduced emergency department (ED) use and medical costs. Methods.- We previously reviewed the complete and detailed school and medical records of all individuals born 1976-1982 in Rochester, Minn, to identify those who met criteria for ADHD between age 5 years and emigration from the area. Stimulant treatment (all start/stop dates, dosages) was also abstracted. This study followed birth cohort members with ADHD in provider-linked billing data from January 1, 1987 (billing data first available), to age 18 for outcomes: ED visits, ED costs, and medical costs. For each outcome, we analyzed associations with 1) any stimulants (yes/no), 2) proportion of follow-up time on stimulants, and 3) among those treated with stimulants, periods on versus off stimulants. Results.- Of 313 youth with ADHD, 231 (74%) received any stimulants; treatment duration ranged from 14 days to 11.8 years. Treated and untreated youth were similar with respect to median annual ED visits (0.5 vs 0.5) and medical costs ($661 vs $741) (P > .05); however, increasing proportion of follow-up on stimulants was associated with fewer ED visits (P= .02) and higher medical costs (P< .001). The 231 treated youth experienced an average of 3.7 periods on and off stimulants; while receiving stimulants, they exhibited fewer ED visits (P= .02), lower ED costs (P = .03), and higher medical costs (P< .001) compared with periods off stimulants. Conclusions.- Among youth with ADH D, extended stimulant treatment is associated with decreased ED visits and ED costs, but higher total medical costs.

Original languageEnglish (US)
Pages (from-to)45-53
Number of pages9
JournalAmbulatory Pediatrics
Issue number1
StatePublished - 2006


  • Attention-deficit/hyperactivity disorder
  • Emergency department
  • Stimulant treatment

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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