TY - JOUR
T1 - Healthcare access and services use among US children with autism spectrum disorder
AU - Lindly, Olivia J.
AU - Zuckerman, Katharine E.
AU - Kuhlthau, Karen A.
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Dr. Lindly’s effort on this project was supported by grant T32HS000063 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the authors and does not necessarily represent official views of the Agency for Healthcare Research and Quality. This work was conducted with support from Harvard Catalyst—The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic healthcare centers. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic healthcare centers, or the National Institutes of Health.
Publisher Copyright:
© The Author(s) 2018.
PY - 2019/8/1
Y1 - 2019/8/1
N2 - This study aimed to determine associations of healthcare access problems with services use among US children with autism spectrum disorder. We analyzed 2011–2014 National Health Interview Survey data on 651 children with autism spectrum disorder aged 2–17 years. There were three measures of healthcare access problems: (1) delays accessing healthcare, (2) difficulty affording healthcare, and (3) trouble finding a primary care provider. There were five service use measures: (1) ⩾4 office visits, (2) ⩾1 well-child visit, (3) flu vaccine, (4) prescription medication, and (5) ⩾1 emergency department visit. Multivariable regression models estimated associations of ⩾1 healthcare access problem with each service use variable and effect modification by socioeconomic status and race and ethnicity. Twenty-nine percent of children with autism spectrum disorder had ⩾1 healthcare access problem. Having ⩾1 healthcare access problem was associated with lower adjusted odds of ⩾1 well-child visit or prescription medication use but higher adjusted odds of ⩾4 office visits or ⩾1 emergency department visit. No significant association was found for flu vaccine. Associations of healthcare access problems with emergency department use were most pronounced for higher socioeconomic status and White, non-Hispanic subgroups. Intervention, such as insurance expansion, is needed to improve healthcare access for children with autism spectrum disorder.
AB - This study aimed to determine associations of healthcare access problems with services use among US children with autism spectrum disorder. We analyzed 2011–2014 National Health Interview Survey data on 651 children with autism spectrum disorder aged 2–17 years. There were three measures of healthcare access problems: (1) delays accessing healthcare, (2) difficulty affording healthcare, and (3) trouble finding a primary care provider. There were five service use measures: (1) ⩾4 office visits, (2) ⩾1 well-child visit, (3) flu vaccine, (4) prescription medication, and (5) ⩾1 emergency department visit. Multivariable regression models estimated associations of ⩾1 healthcare access problem with each service use variable and effect modification by socioeconomic status and race and ethnicity. Twenty-nine percent of children with autism spectrum disorder had ⩾1 healthcare access problem. Having ⩾1 healthcare access problem was associated with lower adjusted odds of ⩾1 well-child visit or prescription medication use but higher adjusted odds of ⩾4 office visits or ⩾1 emergency department visit. No significant association was found for flu vaccine. Associations of healthcare access problems with emergency department use were most pronounced for higher socioeconomic status and White, non-Hispanic subgroups. Intervention, such as insurance expansion, is needed to improve healthcare access for children with autism spectrum disorder.
KW - autism spectrum disorder
KW - emergency medical services
KW - ethnicity
KW - health services accessibility
KW - healthcare disparities
KW - preventive health services
KW - race
KW - socioeconomic status
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U2 - 10.1177/1362361318815237
DO - 10.1177/1362361318815237
M3 - Article
C2 - 30497274
AN - SCOPUS:85059349583
SN - 1362-3613
VL - 23
SP - 1419
EP - 1430
JO - Autism
JF - Autism
IS - 6
ER -