Racial and Ethnic Differences in Subspecialty Service Use by Children With Autism

Abstract

WHAT'S KNOWN ON THIS SUBJECT: Racial and ethnic differences exist in age at diagnosis and early access to mental and behavioral health services among children with autism spectrum disorders (ASDs). ASDs are also associated with increased rates of other medical comorbidities that may require specialty care.WHAT THIS STUDY ADDS: Significant racial and ethnic differences in use of specialty care and specialty procedures exist among children with documented ASD. abstract OBJECTIVE: To describe racial differences in use of specialty care among children with autism spectrum disorder. METHODS:We identified patients ages 2 to 21 years with an International Classification of Diseases, Ninth Revision code of autism (299.0) seen from 2000 to 2011 at a major academic health center by using a research patient data repository and determined rates of specialty provider visits and procedures by race. We then used logistic regression to determine the associations of rates of subspecialty visits and procedures with race and ethnicity, controlling for gender, age, and payer type. RESULTS:We identified 3615 patients (2935 white, 243 Hispanic, 188 African American, and 249 other). The most striking differences were in use of gastroenterology (GI)/nutrition services. Nonwhite children were less likely to use GI/nutrition specialty providers (African American, odds ratio = 0. CONCLUSIONS:We found racial and ethnic differences among children diagnosed with autism in use of care and procedures. Possible explanations for these findings include differences in presentation, referral rates, or referral follow through. Pediatrics 2013;132:94-100

Outpatient Visits and Medication Prescribing for US Children With Mental Health Conditions

“…A study in adult mental health care found a greater disparity in racial and ethnic minorities' access to psychiatrists compared with other providers, 38 and pediatric studies have concluded that disadvantaged groups less frequently see specialists or use prescription medications. 25,[39][40][41][42][43][44] This study has some limitations. Likewise, the extent of management by providers and the depth of discussion at PCP visits could not be determined.…”

Predictors of Age of Diagnosis for Children with Autism Spectrum Disorder: The Role of a Consistent Source of Medical Care, Race, and Condition Severity

“…Minority parents have been shown to follow through with referrals to specialists at a lower rate than Caucasian parents (Zuckerman et al 2011), a difference that has also been established in regards to autism referral attendance (Kalb et al 2012). Minority parents may face more socioeconomic, scheduling, and transportation barriers to visit specialists (Broder-Fingert et al 2013;Kalb et al 2012). They may also hold different beliefs about the importance or seriousness of specialty consultations and are more likely to have had prior negative experiences in specialty care (Broder-Fingert et al 2013).…”

“…Minority parents may face more socioeconomic, scheduling, and transportation barriers to visit specialists (Broder-Fingert et al 2013;Kalb et al 2012). They may also hold different beliefs about the importance or seriousness of specialty consultations and are more likely to have had prior negative experiences in specialty care (Broder-Fingert et al 2013). Another possibility is that parents of different backgrounds self-refer for autism diagnosis at disparate rates.…”

Avances y perspectivas en Síndrome de Asperger

“…Por otra parte, estudios recientes han sugerido que la variación genética común en la población puede contribuir a TEA en un complejo no mendeliano (50)(51)(52)(53)(54).…”