A Rural–Urban Comparison in Emergency Department Visits for U.S. Children with Autism Spectrum Disorder
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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.
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