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Incremental Employee Health Benefit Costs, Absence Days, and Turnover Among Employees With ADHD and Among Employees With Children With ADHD

Kleinman, Nathan L. PhD; Durkin, Michael MS; Melkonian, Arthur MD; Markosyan, Karine PhD, MPH

Journal of Occupational and Environmental Medicine: November 2009 - Volume 51 - Issue 11 - p 1247-1255
doi: 10.1097/JOM.0b013e3181bca68c
Original Articles

Objective: To assess employer economic burden of attention-deficit/hyperactivity disorder (ADHD) for employees with ADHD and employee caregivers of children with ADHD.

Methods: A large multi-employer database was used to compare: 1) employees diagnosed with ADHD versus employees without ADHD and 2) employee caregivers of children with ADHD versus employee caregivers of children without ADHD. Regression modeling compared many employer-relevant outcomes.

Results: The study found significantly higher annual health benefit costs ($6885 versus $4242), absence days (8.86 versus 7.16), and turnover (8.99% versus 5.26%) for employees with ADHD (n = 539) versus employees without ADHD (n = 93,722), respectively (all P < 0.01). Similar results were found for employee caregivers of children with ADHD.

Conclusions: Employees with ADHD and those caring for children with ADHD are associated with a significantly higher burden in employer-relevant outcomes such as health benefit costs, absences, and terminations.

From the Human Capital Management Services (Dr Kleinman, Dr Melkonian, Dr Markosyan), Cheyenne, Wyo; and Ortho-McNeil Janssen Scientific Affairs, LLC (Dr Durkin), Titusville, NJ.

CME Available for this Article at

Nathan Kleinman and coauthors received funding for this research from McNeil Pediatrics, Inc., and Ortho-McNeil Janssen Scientific Affairs, LLC.

The JOEM Editorial Board and planners have no financial interest related to this research.

Address correspondence to: Nathan L. Kleinman, Human Capital Management Services, 1800 Carey Ave, Suite 300, Cheyenne, WY 82001; E-mail:

©2009The American College of Occupational and Environmental Medicine