Health care utilization and expenditures for children with autism: Data from US national samples
ABSTRACT Little is known about the use of medical services by children who have autism (ASD). Provide nationally representative data for health service utilization and expenditures of children with ASD. Cross-sectional survey using the Medical Expenditure Panel (MEPS), and National (Hospital) Ambulatory Medical Care Surveys (N(H)AMCS). A total of 80 children with ASD were identified from N(H)AMCS (weighted sample size (wss) 186,281), and 31 (wss 340,158) from MEPS. They had more outpatient visits, physician visits, and medications prescribed than children in general. They spent more time during physician visits than other children. Annual expenses for children with autism spectrum disorder (6,132 dollars) were more than for other children (860 dollars). Children with ASD have a substantial burden of medical illness.
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ABSTRACT: Background Autism spectrum disorder (ASD) affects many aspects of family life, such as social and economic burden. Little investigation of this phenomenon has been carried out in China. We designed this study to evaluate the employment and financial burdens of families with ASD-diagnosed preschoolers.Methods Four hundred and fifty-nine nuclear families of children with ASD, 418 with some other disability (OD) and 424 with typically developing (TD) children were recruited for this study. Employment and financial burdens of families were evaluated using a structured questionnaire; logistic regression was used to examine differences in job change measures by group, and ordinal logistic regression was used to investigate the association between household income and group.ResultsFifty-eight percent of families with ASD children and 19% of families with OD children reported that childcare problems had greatly affected their employment decisions, compared with 9% of families with TD children (p¿<¿0.001). Age of child, parental education and parental age notwithstanding, having a child with ASD and having a child with OD were both associated with increased odds of reporting that childcare greatly interfered with employment (ASD, OR: 15.936; OD, OR: 2.502; all p¿<¿0.001) and decreased the odds of living in a higher-income household (ASD, estimate¿=¿-1.271; OD, estimate¿=¿-0.569; all p¿<¿0.001). The average loss of annual income associated with having a child with ASD was Chinese RenMinBi (RMB) 44,077 ($7,226), compared with RMB 20,788 ($3,408) for families of OD children.ConclusionsASD is associated with severe employment and financial burdens, much more than for OD, in families with preschool children.BMC Psychiatry 01/2015; 15(1):3. DOI:10.1186/s12888-015-0382-4 · 2.24 Impact Factor
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ABSTRACT: Individuals with intellectual and developmental disabilities (IDD) represent one of the most complex, poorly understood, and under-researched patient populations. The objectives of this review are threefold: (1) first, we provide an overview of existing research on patterns and predictors of emergency department (ED) use among persons with IDD. Population-based studies suggest that individuals with IDD are more likely to visit EDs and to visit more frequently for both physical and mental health issues. We also discuss the predisposing, enabling, and clinical need factors that contribute to emergency service utilization in this population. (2) The second objective is to summarize what is known about the care received by individuals with IDD in the ED. Qualitative research suggests that the care provided is suboptimal from the perspective of patients, their families, and ED health-care providers, with multiple barriers. (3) The final objective is to describe interventions to improve emergency care for persons with IDD, including a pilot evidence-informed approach to implementing practice change in the ED. Our ongoing work is revealing important barriers and enablers to practice change including a discomfort of staff to identify patients with suspected IDD, challenges in developing a system to flag patients with IDD in the ED, the need for educational resources to help adapt their communications and general approach to patients with IDD, and the need to develop and embed tools within the ED care pathway to assist in providing discharge instructions. Crowding and resource limitations within the ED setting may further exacerbate these care challenges and heighten the importance of facilitation in achieving practice changes.International Review of Research in Developmental Disabilities, Edited by Robert M. Hodapp, 01/2014: chapter 1: pages 1-37;
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DESCRIPTION: Nachshen, J., Garcin, N., Moxness, K., Tremblay, Y., Hutchinson, P., Lachance, A., Beaurivage, M., Breitenbach, M., Bryson, S., Burack, J., Caron, C., Condillac, R. A., Cornick, A., Ouellette-Kuntz, H., Joseph, S., Rishikof, E., Sladeczek, I. E., Steiman, M., Tidmarsh, L., Zwaigenbaum, L., Fombonne, E., Szatmari, P., Martin-Storey, A., & Ruttle, P.L. (2008). Screening, Assessment, and Diagnosis of Autism Spectrum Disorders in Young Children: Canadian Best Practice Guidelines. Miriam Foundation, Montreal, Quebec.