A Rural–Urban Comparison in Emergency Department Visits for U.S. Children with Autism Spectrum Disorder
- 525 Downloads
We examined rural–urban differences in emergency department visits, and child and clinical characteristics associated with visits for U.S. children aged 3–17 years with autism spectrum disorder (ASD). Rural children with ASD were twice more likely to have emergency department visits in urban hospitals than rural children without ASD. The children with ASD in rural areas were economically disadvantaged and concentrated in the South and Midwest regions. Rural children diagnosed with ASD and multiple comorbidities during emergency department visits were 1.6 times as that of urban children. Rural children with ASD, particularly those with multiple comorbidities, require more emergency department services when compared with urban children with ASD.
KeywordsEmergency department visits Autism spectrum disorder (ASD) Rural–urban differences Utilization of health services
This study was supported by Grant # R40MC27475-01-05, MCH Research Program, from the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. The authors would like to acknowledge the Healthcare Cost and Utilization Project (HCUP) for supplying the data for this analysis.
Dr. WZ conceived of the study, participated in its design and coordination, drafted the manuscript, and performed the statistical analysis; Ms. AEM participated in its design and coordination, performed the measurement, and helped to draft the manuscript; Dr. BB conceived of the study, participated in the design and interpretation of the data; Dr. LS participated in the design and interpretation of the data; Dr. GB participated in the design and coordination of the study, and interpretation of the data. All authors read and approved the final manuscript.
This study was funded by a Grant from the Maternal and Child Health Bureau (R40MC27475-01-05)
Compliance with Ethical Standards
Conflict of interest
Dr. Zhang, Ms. Mason, Dr. Boyd, Dr. Sikich, and Dr. Baranek declares that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
- Anderson, N., Neuwirth, S., Lenardson, J. D., & Hartley, D. (2013). Patterns of care for rural and urban children with mental health problems. Working Paper #49. Maine Rural Health Research Center. Retrieved April 12, 2015, from http://muskie.usm.maine.edu/Publications/MRHRC/WP49-Rural-Children-Mental-Health.pdf.
- Centers for Disease Control (2012). Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveillance Summary, 61(2), 1–21.Google Scholar
- Hall, M. J., Marstellar, J., & Owings, M. (2010). National Health Statistics Report: Factors Influencing Rural Residents’ Cite Utilization of Urban Hospitals. Retrieved May 14, 2015, from http://www.cdc.gov/nchs/data/nhsr/nhsr031.pdf.
- Healthcare Cost and Utilization Project (HCUP) (2011). HCUP Nationwide Emergency Department Sample (NEDS). Rockville, MD: Agency for Healthcare Research and Quality.Google Scholar
- Institute of Medicine (2007). Emergency care for children: Growing pains. Washington, DC: The National Institute Press.Google Scholar
- Lambert, D., Ziller, E. C., & Lenardson, J. D. (2008). Use of mental health services by rural children. Working Paper #39. Maine Rural Health Research Center. Retrieved April 12, 2015, from http://muskie.usm.maine.edu/Publications/rural/WP39/Rural-Children-Mental-Health-Services.pdf.
- Lenardson, J. D., Ziller, E. C., Coburn, A. F., & Anderson, N. J. (2009). Profile of rural health insurance coverage: A chartbook. Rural Health Research & Policy Centers. Retrieved May 20, 2015, from https://muskie.usm.maine.edu/Publications/rural/Rural-Health-Insurance-Chartbook-2009.pdf.
- Merrill, C. T., Owens, P. L., & Stocks C. (2008). Pediatric department visits in community hospitals from selected States. HCUP Statistical Brief #52. Agency for Healthcare Research and Quality, Rockville, MD. Retrieved June 24, 2015, from https://www.hcup-us.ahrq.gov/reports/statbriefs/sb52.jsp.
- Murphy, M. A., & Ruble, L. A. (2012). A comparative study of rurality and urbanicity on access to and satisfaction with services for children with autism spectrum disorders. Rural Special Education Quarterly, 31:3–11. Retrieved July 20, 2015 from http://autismservicesresearchgroup.weebly.com/uploads/1/3/9/2/13923263/murphy.pdf.
- 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 & Adolescent Psychiatry, 47(8), 921–929.CrossRefGoogle Scholar
- Strang, J. F., Kenworthy, L., Daniolos, P., Case, L., Wills, M. C., Martin, A., et al. (2012). Depression and anxiety symptoms in children and adolescents with autism spectrum disorders without intellectual disability. Research in Autism Spectrum Disorders, 6(1), 406–412.CrossRefPubMedPubMedCentralGoogle Scholar
- VanLandeghem, K., & Brown, T. (2012). The affordable care act and children and youth with autism spectrum disorder and other developmental disabilities. The Association of Maternal & Child Health Programs (AMCHP) issue brief. Retrieved March 22, 2015, from http://www.amchp.org/Policy-Advocacy/health-reform/resources/Documents/ACA_AutismFactSheet_5-3-12.pdf.