Impact of the owner-pet and client-veterinarian bond on the care that pets receive I n 2006, a task force representing a dozen companion-animal health industry suppliers, medical providers, and associations gathered to discuss how companion-animal practices would maintain growth amidst ongoing struggles with static service growth and poor compliance results. The group questioned the level of consumer willingness to undertake veterinarian care for sick or injured pets as well as to maintain wellness programs involving ongoing examinations, vaccinations, preventive dental care, and other products and services. Until now, virtually no national comprehensive research had been conducted on the perceptions and attitudes of consumers toward veterinary care and their willingness to purchase related products and services. The task force commissioned BNResearch of Portland, Ore, to conduct a national study of pet owners to research their perceptions and attitudes. The Industry Task Force includes the AVMA; Banfield,
Using data from multiple health systems (2009–2010) and the largest sample to date, this study compares health services use among youth with and without an autism spectrum disorder (ASD) – including preventive services not previously studied. To examine these differences, we estimated logistic and count data models, controlling for demographic characteristics, comorbid physical health, and mental health conditions. Results indicated that youth with an ASD had greater health care use in many categories, but were less likely to receive important preventive services including flu shots and other vaccinations. An improved understanding of the overall patterns of health care use among this population could enable health systems to facilitate the receipt of appropriate and effective health care.
Purpose To identify factors associated with valid Autism Spectrum Disorder diagnoses from electronic sources in large healthcare systems. Methods We examined 1,272 charts from ASD diagnosed youth < 18 years old. Expert reviewers classified diagnoses as confirmed, probable, possible, ruled out, or not enough information. Results A total of 845 were classified with 81% as a confirmed, probable, or possible ASD diagnosis. The predictors of valid ASD diagnoses were > 2 diagnoses in the medical record (OR = 2.94; 95% CI = 2.03-4.25; p < 0.001) and being male (OR = 1.51; 95% CI = 1.05-2.17; p = 0.03). Conclusions In large integrated healthcare settings, at least two diagnoses can be used to identify ASD patients for population-based research.
This study examines medical conditions diagnosed prior to the diagnosis of autism spectrum disorder (ASD). Using a matched case control design with 3911 ASD cases and 38,609 controls, we found that 38 out of 79 medical conditions were associated with increased ASD risk. Developmental delay, mental health, and neurology conditions had the strongest associations (ORs 2.0–23.3). Moderately strong associations were observed for nutrition, genetic, ear nose and throat, and sleep conditions (ORs 2.1–3.2). Using machine learning methods, we clustered children based on their medical conditions prior to ASD diagnosis and demonstrated ASD risk stratification. Our findings provide new evidence indicating that children with ASD have a disproportionate burden of certain medical conditions preceding ASD diagnosis.Electronic supplementary materialThe online version of this article (doi:10.1007/s10803-017-3130-4) contains supplementary material, which is available to authorized users.
Introduction: Autism spectrum disorders (ASD) are lifelong neurodevelopmental disorders, and little is known about how parents address the health and psychosocial consequences of ASD. Few studies have examined use of various treatments and services in a large, diverse sample of children with ASD and their families.Objective: This paper presents methods to create an autism research resource across multiple large health delivery systems and describes services and treatments used by children with ASD and their families.Methods: Four study sites conducted a Web survey of parents of children and adolescents with ASD who were members of Kaiser Permanente. We tabulated data distributions of survey responses and calculated c 2 statistics for differences between responders and nonresponders.Results: The children of the 1155 respondents were racially and ethnically diverse (55% white, 6% black, 5% Asian, 9% multiracial, 24% Hispanic) and representative of the total population invited to participate with respect to child sex (83% male), child age (57% < 10 years), and ASD diagnosis (64% autistic disorder). The most frequently used services and treatments were Individualized Education Programs (85%), family physician visits (78%), and occupational and speech therapy (55% and 60%, respectively). Home-based programs frequently included implementation of social skills training (44%) and behavior management (42%). Prescription medication use was high (48%). Caregivers reported disruption of personal and family routines because of problem behaviors.Conclusion: These survey data help to elucidate parents' experiences with health services for their children with ASD and serve as a potential resource for future research.
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