Patterns of emergency department utilization by autistic patients in a large NY health system

Sensory reactivity and communication challenges can complicate navigating the healthcare system and managing health concerns for autistic individuals.

Emergency department (ED) encounters for autistic and non-autistic patients from 2023 within 14 hospitals of a large NY healthcare system were evaluated using ICD-10 code F84.0. Outcomes included: percentage of patients accessing care, top primary diagnoses, ED utilization across various ages, admission status, and duration of hospitalization.

The study included 711,254 ED visits from 523,057 patients. 1228 patients were documented autistic (0.23 %), which was statistically significantly less than the expected autistic population proportion (p < 0.0001). We found a significant association between age group and autism diagnosis (p < 0.0001), with there being higher proportions of autistic patients in younger age groups. 12.3 % of encounters with autistic patients resulted in admission to the hospital, compared to 23.3 % of the patients without this documented diagnosis (p < 0.0001). The median length of hospitalization for patients with documented autism was shorter (4 days (IQR 2-7)) and 3 days ((IQR 1-6)) (p < 0.0001) for non-autistic and autistic patients, respectively).

In this study, autistic patients utilized the ED at a lower rate than would be expected given the prevalence of autism. The majority of autistic patients seen in the ED were younger (<30 years old). The primary diagnosis varied between autistic and non-autistic patients. Further study is needed to better characterize the challenges seeking care throughout healthcare settings and ensure adequate healthcare supports for the autistic community.