PS1-39: Health Care Utilization for Children With and Without Autism Spectrum Disorders in Five Large Health Systems

Abstract

Background/AimsApproximately 1 in 88 children in the U.S. is diagnosed with Autism Spectrum Disorder (ASD). ASD is a complex disorder characterized by impairment in social skills, communication, and cognitive and behavioral functioning. Several studies have indicated that children with ASD use a different pattern of health services than typically developing children. However, most previous studies have included small samples, or only included one health system. The purpose of this analysis is to examine patterns of health service use in a large group of geographically- and racially/ethnically-diverse children with ASD enrolled in the Mental Health Research Network (MHRN) Autism Registry.MethodsData from 2009 and 2010 from the virtual data warehouse (VDW) of 5 health plans was used to collect comprehensive information on patterns of health services for children with ASD and a comparison group of children without ASD. Comparisons of the patterns of service use in the two groups were conducted. Two part models of service use were used. In the first stage, logistic regression was used to examine the likelihood of any use of services. In the second stage, negative binomial regression was used to examine the level of use services.ResultsThe study includes 8,363 children with ASD and 83,575 comparison children, making it the largest study of patterns of ASD service use to date. Preliminary results indicate that children with ASD were significantly more likely to use most types of services including speech therapy (OR 12.2; 95% CI 10.9–13.9), mental health (OR 8.9; 95% CI 8.4–9.5), and neurology (OR 8.3; 95% CI 7.6–9.1). In contrast, they were significantly less likely to use some services including vaccinations (OR .80; 95% CI .75–.85).ConclusionsChildren with ASD have significant physical and mental health needs related to their condition and these are reflected in increased use of services in many categories. However, in some cases children with ASD receive fewer important health care services, notably vaccinations. Better understanding of the needs of children with ASD, family beliefs and preferences, and systematic coordination of care for these children could aid in helping families to use health care services most effectively.