Emergency Department Use Among Adults with Autism Spectrum Disorders (ASD)

Vohra, Rini; Madhavan, Suresh; Sambamoorthi, Usha

doi:10.1007/s10803-015-2692-2

Cited by 84 publications

(96 citation statements)

References 47 publications

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“…21,[45][46][47][48] Our results are also similar to those reported in a recent study of Medicaid recipients that found that, on average, adults with ASD have more outpatient visits and more prescription drug claims per year than adults without ASD. 18 Like a number of previous studies, [34][35][36] we found that adults with ASD were more likely than adults without ASD to have emergency room visits. However, after controlling for covariates and stratifying by age category, we found that this difference was only significant for adults who were 50 years or older.…”

Section: Discussionsupporting

confidence: 80%

“…21,23,[28][29][30][31][32] Although previous research suggests that health care utilization patterns may change over the life course, 33 very little is known about health care utilization patterns among adults with ASD. Recent studies reported higher rates of ED visits [34][35][36][37] and lower rates of tetanus vaccination and cervical cancer screening among adults with ASD than among controls. 34 The reasons for higher utilization of ED visits by ASD cases are not well understood and may be multifactorial.…”

mentioning

confidence: 99%

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Health Care Service Utilization and Cost Among Adults with Autism Spectrum Disorders in a U.S. Integrated Health Care System

ZerboOusseny

QianYinge

RayThomas

et al. 2019

Autism in Adulthood

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Objectives: To compare health care utilization patterns and cost among insured adults with autism spectrum disorder (ASD), adults with attention-deficit and hyperactivity disorder (ADHD), and adults with neither condition (general population [GP] controls). Method: We conducted a case-control study among adults (q18 years) who were members of Kaiser Permanente Northern California (KPNC) for at least 9 months each year from 2008 to 2012. Cases (N = 1507) were adults with an ASD diagnosis (ICD-9-CM 299.0-299.8) recorded in the electronic medical record on at least two separate occasions by December 31, 2012. Two control groups, adults with ADHD (N = 9042) defined by ICD-9-CM code 314 and GP (N = 15,070), were randomly selected and frequency matched to cases on gender and age. Health care utilization and cost data were obtained from KPNC databases for the year 2012. Results: Compared with adults with ADHD, adults with ASD had significantly higher utilization of outpatient visits for primary care (74.2% vs. 66.6%), mental health (43.3% vs. 33.2%), and laboratory services (60.9% vs. 54.4%). Hospitalizations for ambulatory care sensitive diagnoses (5.4% vs. 2.3%) were less frequent overall but more common among adults with ASD than with ADHD. Group differences were larger comparing adults with ASD with GP controls. Gynecology visits and screening for cervical cancer were significantly less common among women with ASD than among women with ADHD (35% vs. 50%) or GP (35% vs. 49%). Total annual mean healthcare costs for adults with ASD were 20% higher than costs for adults with ADHD and double costs for GP. Conclusion: Adults with ASD had significantly higher rates of utilization across most health care service areas compared with adults with ADHD or GP; however, women with ASD were significantly less likely to have gynecology visits and have screening for cervical cancer.

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Section: Discussionsupporting

confidence: 80%

mentioning

confidence: 99%

Health Care Service Utilization and Cost Among Adults with Autism Spectrum Disorders in a U.S. Integrated Health Care System

ZerboOusseny

QianYinge

RayThomas

et al. 2019

Autism in Adulthood

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“…Co-occurring conditions/symptoms increase the societal impact of ASD, since they often contribute to a higher level of impairment, increased need for services, including medications and emergency rooms visits for injuries, impacting the quality of life of children with ASD and their families (Gurney et al 2006; Ianuzzi et al 2015; Malow et al 2016; Peacock et al 2012; Posserud et al 2018; Schieve et al 2012; Sikora et al 2012; Vohra et al 2016). …”

Section: Introductionmentioning

confidence: 99%

Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

Soke

Maenner

Christensen

et al. 2018

J Autism Dev Disord

149

153

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We compared the prevalence of various medical and behavioral co-occurring conditions/symptoms between 4- and 8-year-olds with autism spectrum disorder (ASD) from five sites in the Autism and Developmental Disabilities Monitoring Network during the 2010 survey year, accounting for sociodemographic differences. Over 95% of children had at least one co-occurring condition/symptom. Overall, the prevalence was higher in 8- than 4-year-olds for 67% of co-occurring conditions/symptoms examined. Further, our data suggested that co-occurring conditions/symptoms increased or decreased the age at which children were first evaluated for ASD. Similarly, among the 8-year-olds, the prevalence of most co-occurring conditions/symptoms was higher in children with a previous ASD diagnosis documented in their records. These findings are informative for understanding and screening co-occurring conditions/symptoms in ASD.

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“…Specifically, there is a notably greater prevalence of sleep disorders, epilepsy, food intolerance, gastrointestinal dysfunction, mood disorder and self-injurious behaviours [13], and high prevalence of diabetes mellitus, hypertension and obesity [14]. Inhospital mortality is increased [15] and autistic people are three times more likely to use emergency departments, to require inpatient admission, and to die after attending emergency care [16].…”

Section: Introductionmentioning

confidence: 99%

Barriers to healthcare for autistic adults: Consequences & policy implications. A cross-sectional study

Doherty

Neilson

O’Sullivan

et al. 2020

Preprint

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Background: Autism is associated with reduced life expectancy, poor physical and mental health, and increased prevalence of epilepsy, obesity, hypertension, diabetes and stroke. Aim: To quantify self-reported barriers to healthcare and their consequences amongst autistic adults and compare with parents of autistic children and non-autistic controls Design and Setting: An online survey was developed from a qualitative study undertaken at Autscape, an autistic conference. Method: Thematic analysis of 75 responses was used to develop a 57-item online survey completed by 1,271 autistic adults, 406 parents of autistic children and 303 control subjects. Results: Difficulty visiting a GP was reported by 78.2% of autistic adults, 51.4% of parents and 34.9% of controls. The highest-rated barriers by autistic adults were deciding if symptoms warrant a GP visit (71.9%), difficulty using the telephone to book appointments (60.7%), not feeling understood (55.5%) and difficulty communicating with their doctor (53.0%). A higher rate of adverse health outcomes was reported by autistic adults; untreated physical and mental health conditions, not attending specialist referral or screening programmes, requiring more extensive treatment or surgery due to late presentations, and untreated potentially life threatening conditions. Autistic adults reported a need for online or text based appointment booking, facility to email in advance the reason for consultation, first or last clinic appointment and a quiet place to wait. Conclusion: Reduction of healthcare inequalities for autistic people requires that healthcare providers understand autistic culture and communication needs. Adjustments for autistic communication needs are as necessary as ramps are for wheelchair users.

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Emergency Department Use Among Adults with Autism Spectrum Disorders (ASD)

Cited by 84 publications

References 47 publications

Health Care Service Utilization and Cost Among Adults with Autism Spectrum Disorders in a U.S. Integrated Health Care System

Health Care Service Utilization and Cost Among Adults with Autism Spectrum Disorders in a U.S. Integrated Health Care System

Prevalence of Co-occurring Medical and Behavioral Conditions/Symptoms Among 4- and 8-Year-Old Children with Autism Spectrum Disorder in Selected Areas of the United States in 2010

Barriers to healthcare for autistic adults: Consequences & policy implications. A cross-sectional study

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