Do Children with Autism Overutilize the Emergency Department? Examining Visit Urgency and Subsequent Hospital Admissions.

Background Children with autism spectrum disorders (ASD) are more likely to have difficulties accessing health care compared to other children with special health care needs. National data based on parent report indicate that children with ASD are overutilizing emergency department (ED) services, bu...

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Published in:Maternal & Child Health Journal Vol. 20; no. 2; pp. 306 - 315
Main Authors: Deavenport-Saman, Alexis, Lu, Yang, Smith, Kathryn, Yin, Larry
Format: research tables/charts Journal Article
Published: Springer Nature Feb2016
Online Access:View this record in EBSCOhost
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      dt: Feb2016
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      pub: Springer Nature
      place: New York, New York
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        atl: Do Children with Autism Overutilize the Emergency Department? Examining Visit Urgency and Subsequent Hospital Admissions.
      aug:
        au:
          Deavenport-Saman, Alexis
          Lu, Yang
          Smith, Kathryn
          Yin, Larry
        affil: Department of Pediatrics, Harbor-UCLA Medical Center & Los Angeles Biomedical Research Institute, Torrance USA
      sug:
        subj:
          Autism Spectrum Disorder
          Emergency Service Utilization
          Patient Admission
          Health Services Accessibility
          Human
          Hospitals, Pediatric
          California
          Retrospective Design
          Multivariate Analysis
          Linear Regression
          Logistic Regression
          Odds Ratio
          Confidence Intervals
          Conceptual Framework
          Child, Preschool
          Child
          Adolescence
          Young Adult
          Male
          Female
          Bivariate Statistics
          Data Analysis Software
          T-Tests
          Health Care Costs
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Background Children with autism spectrum disorders (ASD) are more likely to have difficulties accessing health care compared to other children with special health care needs. National data based on parent report indicate that children with ASD are overutilizing emergency department (ED) services, but data on actual ED use has been limited to children with psychiatric diagnoses. This study examined factors associated with ED utilization (rate, urgency, and hospital admissions) among children with ASD compared to those without ASD. Methods Data from an urban, tertiary children's hospital level 1 trauma center were examined retrospectively 2006-2009. Anderson's model of health services utilization served as the study framework. The NYU ED algorithm was used to predict nonurgent visits. Multivariate linear and logistic regression analyses were performed on the rate, urgency, and subsequent hospital admissions of these ED visits. Results There were 115,443 children 2-21 years old, accounting for a total of 157,902 visits. The top three reasons for visiting the ED for children with and without ASD were acute upper respiratory infections, viral infections and otitis media. Children with ASD had on average 0.26 more ED visits annually than children without ASD ( p < 0.01) and were 2.6 % points more likely to have nonurgent visits; p < 0.01). Their visits were also less likely to result in hospital admissions (OR 0. 61; p < 0.01). Conclusions Examination of predisposing, enabling, and reinforcing factors suggest that children with ASD were more likely to visit the ED and for nonurgent reasons.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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