Journal of Autism and Developmental Disorders

, Volume 46, Issue 3, pp 910–920 | Cite as

Health Services Utilization Among Children With and Without Autism Spectrum Disorders

  • Janet R. Cummings
  • Frances L. Lynch
  • Kristal C. Rust
  • Karen J. Coleman
  • Jeanne M. Madden
  • Ashli A. Owen-Smith
  • Vincent M. Yau
  • Yinge Qian
  • Kathryn A. Pearson
  • Phillip M. Crawford
  • Maria L. Massolo
  • Virginia P. Quinn
  • Lisa A. Croen
Original Paper

Abstract

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.

Keywords

Autism spectrum disorders Health care utilization Preventive services Children Adolescents 

Supplementary material

10803_2015_2634_MOESM1_ESM.doc (59 kb)
Supplementary material 1 (DOC 59 kb)

References

  1. American Academy of Pediatrics. (2014). Well-child care: A check-up for success. http://www.healthychildren.org/English/family-life/health-management/Pages/Well-Child-Care-A-Check-Up-for-Success.aspx. Accessed March 2015.
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. In American Psychiatric Association (5th ed.). dsm.psychiatryonline.org. Accessed February 1, 2015.
  3. Andre, F., et al. (2008). Vaccination greatly reduces disease, disability, death and inequity worldwide. Bulletin of the World Health Organization, 86, 140–146.PubMedCentralCrossRefPubMedGoogle Scholar
  4. Bowen, S. E. (2014). Autism spectrum disorders (ASD): State of the states of services and supports for people with ASD. Washington, DC: L & M Policy Research LLC.Google Scholar
  5. Centers for Disease Control and Prevention. (2014). People at high risk of developing flu-related complications. http://www.cdc.gov/flu/about/disease/high_risk.htm. Accessed March 2015.
  6. Cidav, Z., Lawer, L., Marcus, S. C., & Mandell, D. S. (2013). Age-related variation in health service use and associated expenditures among children with autism. Journal of Autism and Developmental Disorders, 43, 924–931. doi:10.1007/s10803-012-1637-2.CrossRefPubMedGoogle Scholar
  7. Copeland, L., & Buch, G. (2013). Early intervention issues in autism spectrum disorders. Autism: The international Journal of Research and Practice, 3, 109.Google Scholar
  8. Croen, L. A., Najjar, D. V., Ray, G. T., Lotspeich, L., & Bernal, P. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118, e1203–e1211. doi:10.1542/peds.2006-0127.CrossRefPubMedGoogle Scholar
  9. Eisenberg, K. W., et al. (2008). Vaccine effectiveness against laboratory-confirmed influenza in children 6 to 59 months of age during the 2003–2004 and 2004–2005 influenza seasons. Pediatrics, 122, 911–919. doi:10.1542/peds.2007-3304.PubMedCentralCrossRefPubMedGoogle Scholar
  10. Ferdinands, J. M., et al. (2014). Effectiveness of influenza vaccine against life-threatening RT-PCR-confirmed influenza illness in US children, 2010–2012. The Journal of Infectious Diseases, 210, 674–683. doi:10.1093/infdis/jiu185.CrossRefPubMedGoogle Scholar
  11. Fombonne, E. (2003). Epidemiological surveys of autism and other pervasive developmental disorders: An update. Journal of Autism and Developmental Disorders, 33, 365–382.CrossRefPubMedGoogle Scholar
  12. Fontana, S. A., Baumann, L. C., Helberg, C., & Love, R. R. (1997). The delivery of preventive services in primary care practices according to chronic disease status. American Journal of Public Health, 87, 1190–1196.PubMedCentralCrossRefPubMedGoogle Scholar
  13. Gadomski, A., Jenkins, P., & Nichols, M. (1998). Impact of a Medicaid primary care provider and preventive care on pediatric hospitalization. Pediatrics, 101, e1. CrossRefPubMedGoogle Scholar
  14. Godlee, F., Smith, J., & Marcovitch, H. (2011). Wakefield’s article linking MMR vaccine and autism was fraudulent. BMJ, 342, c7452. doi:10.1136/bmj.c7452.CrossRefPubMedGoogle Scholar
  15. Golnik, A., Ireland, M., & Borowsky, I. W. (2009). Medical homes for children with autism: A physician survey. Pediatrics, 123, 966–971. doi:10.1542/peds.2008-1321.CrossRefPubMedGoogle Scholar
  16. Gurney, J. G., McPheeters, M. L., & Davis, M. M. (2006). Parental report of health conditions and health care use among children with and without autism: National Survey of Children’s Health. Archives of Pediatrics and Adolescent Medicine, 160, 825–830. doi:10.1001/archpedi.160.8.825.CrossRefPubMedGoogle Scholar
  17. Howlin, P., Magiati, I., & Charman, T. (2009). Systematic review of early intensive behavioral interventions for children with autism. American Journal on Intellectual and Developmental Disabilities, 114, 23–41. doi:10.1352/2009.114:23;nd41.CrossRefPubMedGoogle Scholar
  18. Hyman, S., & Johnson, J. (2012). Autism and pediatric practice: Toward a medical home. Journal of Autism and Developmental Disorders, 42, 1156–1164. doi:10.1007/s10803-012-1474-3.CrossRefPubMedGoogle Scholar
  19. Joshi, G., et al. (2010). The heavy burden of psychiatric comorbidity in youth with autism spectrum disorders: A large comparative study of a psychiatrically referred population. Journal of Autism and Developmental Disorders, 40, 1361–1370. doi:10.1007/s10803-010-0996-9.CrossRefPubMedGoogle Scholar
  20. Keren, R., Zaoutis, T. E., Bridges, C. B., et al. (2005). Neurological and neuromuscular disease as a risk factor for respiratory failure in children hospitalized with influenza infection. JAMA, 294, 2188–2194. doi:10.1001/jama.294.17.2188.CrossRefPubMedGoogle Scholar
  21. Levy, S. E., et al. (2010). Autism spectrum disorder and co-occurring developmental, psychiatric, and medical conditions among children in multiple populations of the United States. Journal of Developmental and Behavioral Pediatrics: JDBP, 31, 267–275. doi:10.1097/DBP.0b013e3181d5d03b.CrossRefPubMedGoogle Scholar
  22. Liptak, G. S., Kennedy, J. A., & Dosa, N. P. (2011). Social participation in a nationally representative sample of older youth and young adults with autism. Journal of Developmental and Behavioral Pediatrics: JDBP, 32, 277–283. doi:10.1097/DBP.0b013e31820b49fc.CrossRefPubMedGoogle Scholar
  23. Liptak, G. S., Stuart, T., & Auinger, P. (2006). Health care utilization and expenditures for children with autism: Data from U.S. national samples. Journal of Autism and Developmental Disorders, 36, 871–879. doi:10.1007/s10803-006-0119-9.CrossRefPubMedGoogle Scholar
  24. Long, J. S. (1997). Count outcomes: Regression models for counts. In Regression models for categorical and limited dependent variables. Advanced quantitative techniques in the social sciences (pp. 217–250). Thousand Oaks, CA: Sage Publications.Google Scholar
  25. Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63, 694–701. doi:10.1001/archpsyc.63.6.694.CrossRefPubMedGoogle Scholar
  26. Medicode (Firm). (1996). ICD-9-CM: International classification of diseases, 9th revision, clinical modification. Salt Lake City, UT: Medicode.Google Scholar
  27. Mental Health Research Network. (2015). Mental Health Research Network participating members: 13 sites across the U.S. https://sites.google.com/a/mhresearchnetwork.org/mhrn/home/Members. Accessed April 21, 2015.
  28. Myers, S. M., Johnson, C. P., & The Council on Children with Disabilities. (2007). Management of children with autism spectrum disorders. Pediatrics, 120, 1162–1182. doi:10.1542/peds.2007-2362.CrossRefPubMedGoogle Scholar
  29. Omer, S. B., Salmon, D. A., Orenstein, W. A., deHart, M. P., & Halsey, N. (2009). Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases. The New England Journal of Medicine, 360, 1981–1988. doi:10.1056/NEJMsa0806477.CrossRefPubMedGoogle Scholar
  30. Pan, C. Y., & Frey, G. C. (2006). Physical activity patterns in youth with autism spectrum disorders. Journal of Autism and Developmental Disorders, 36, 597–606. doi:10.1007/s10803-006-0101-6.CrossRefPubMedGoogle Scholar
  31. Rogers, S. J., & Ozonoff, S. (2005). Annotation: What do we know about sensory dysfunction in autism? A critical review of the empirical evidence. Journal of Child Psychology and Psychiatry and Allied Disciplines, 46, 1255–1268. doi:10.1111/j.1469-7610.2005.01431.x.CrossRefGoogle Scholar
  32. Selden, T. M. (2006). Compliance with well-child visit recommendations: Evidence from the Medical Expenditure Panel Survey, 2000–2002. Pediatrics, 118, e1766–e1778. doi:10.1542/peds.2006-0286.CrossRefPubMedGoogle Scholar
  33. Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 921–929. doi:10.1097/CHI.0b013e318179964f.CrossRefPubMedGoogle Scholar
  34. StataCorp LP. (2013). Stata Statistical Software (13.1 ed). College Station, TX.Google Scholar
  35. Taylor, B., et al. (1999). Autism and measles, mumps, and rubella vaccine: No epidemiological evidence for a causal association. Lancet, 353, 2026–2029.CrossRefPubMedGoogle Scholar
  36. Thomas, K. C., Ellis, A. R., McLaurin, C., Daniels, J., & Morrissey, J. P. (2007). Access to care for autism-related services. Journal of Autism and Developmental Disorders, 37, 1902–1912. doi:10.1007/s10803-006-0323-7.CrossRefPubMedGoogle Scholar
  37. U.S. Census Bureau. (2000, 2006–2010). United States Census, American Community Survey. http://www.census.gov/acs/www/.
  38. Van Cleave, J., & Davis, M. M. (2008). Preventive care utilization among children with and without special health care needs: Associations with unmet need. Ambulatory Pediatrics, 8, 305–311. doi:10.1016/j.ambp.2008.04.003.CrossRefPubMedGoogle Scholar
  39. Van Cleave, J., Heisler, M., Devries, J. M., Joiner, T. A., & Davis, M. M. (2007). Discussion of illness during well-child care visits with parents of children with and without special health care needs. Archives of Pediatrics and Adolescent Medicine, 161, 1170–1175. doi:10.1001/archpedi.161.12.1170.CrossRefPubMedGoogle Scholar
  40. Yarnall, K. S., Pollak, K. I., Ostbye, T., Krause, K. M., & Michener, J. L. (2003). Primary care: Is there enough time for prevention? American Journal of Public Health, 93, 635–641.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Janet R. Cummings
    • 1
  • Frances L. Lynch
    • 2
  • Kristal C. Rust
    • 2
  • Karen J. Coleman
    • 3
  • Jeanne M. Madden
    • 4
    • 5
  • Ashli A. Owen-Smith
    • 6
    • 7
  • Vincent M. Yau
    • 8
    • 9
  • Yinge Qian
    • 8
  • Kathryn A. Pearson
    • 2
  • Phillip M. Crawford
    • 2
  • Maria L. Massolo
    • 8
  • Virginia P. Quinn
    • 3
  • Lisa A. Croen
    • 8
  1. 1.Department of Health Policy and Management, Rollins School of Public HealthEmory UniversityAtlantaUSA
  2. 2.The Center for Health Research/NorthwestKaiser Permanente Northwest (KPNW)PortlandUSA
  3. 3.Department of Research & EvaluationKaiser Permanente Southern California (KPSC)PasadenaUSA
  4. 4.School of PharmacyNortheastern UniversityBostonUSA
  5. 5.Department of Population MedicineHarvard Medical School and Harvard Pilgrim Health Care Institute (HPHCI)BostonUSA
  6. 6.Division of Health Management and Policy, School of Public HealthGeorgia State UniversityAtlantaUSA
  7. 7.Center for Clinical and Outcomes ResearchKaiser Permanente Georgia (KPGA)AtlantaUSA
  8. 8.Division of ResearchKaiser Permanente Northern California (KPNC)OaklandUSA
  9. 9.McKesson CorporationSan FranciscoUSA

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