Healthcare access and services use among US children with autism spectrum disorder

Area of Science:

• Pediatric Healthcare
• Autism Spectrum Disorder Research
• Health Services Research

Background:

• Access to healthcare is crucial for children with autism spectrum disorder (ASD).
• Understanding how healthcare access problems impact service utilization in this population is essential for targeted interventions.
• Previous research has highlighted disparities in healthcare access for children with ASD.

Purpose of the Study:

• To examine the associations between healthcare access problems and the use of various healthcare services among US children with ASD.
• To identify specific service use patterns associated with delayed access, affordability issues, and difficulties finding primary care providers.
• To explore potential effect modification by socioeconomic status and race/ethnicity.

Main Methods:

• Analysis of data from the 2011-2014 National Health Interview Survey.
• Inclusion of 651 children aged 2-17 years diagnosed with ASD.
• Use of multivariable regression models to assess associations between healthcare access problems (delays, affordability, provider access) and service use (office visits, well-child visits, flu vaccine, prescriptions, emergency department visits).

Main Results:

• Twenty-nine percent of children with ASD experienced at least one healthcare access problem.
• Healthcare access problems were associated with lower odds of well-child visits and prescription medication use.
• Conversely, access problems were linked to higher odds of frequent office visits and emergency department use, particularly among higher socioeconomic status and White, non-Hispanic children.

Conclusions:

• Healthcare access problems significantly influence service utilization patterns in children with ASD.
• Specific access barriers correlate with both underuse (preventive care, medications) and overuse (emergency care) of services.
• Interventions, including insurance expansion, are necessary to mitigate these access barriers and improve healthcare delivery for children with ASD.