Health Care Quality for US Children with Autism Spectrum Disorder

Health Care Quality for US Children with Autism Spectrum Disorder:

An Examination of Trends between 2007 and 2011

ID: 21443; Password: 404354

Purpose: Recent research continues to demonstrate rising autism spectrum disorder (ASD) prevalence among US children, with as many as 1 in 50 school-age children having this condition. Children with ASD are more prone than both other children with special health care needs (CSHCN-ASD) and other children (Non-CSHCN) to experience adverse health impacts in addition to family financial and employment burden. Quality health care, which is measured at the population-level by the National Survey of Children’s Health (NSCH), may have the potential to promote health across the life course for and reduce the costs incurred by this especially vulnerable subpopulation of children. The present study therefore examined trends in health care quality for US children with ASD relative to both CSHCN without ASD (CSHCN-ASD) and Non-CSHCN between 2007 and 2011.

Methods: Data weighted to represent the non-institutionalized population of US children age 2-17 years were drawn from the 2007 NSCH and 2011-12 NSCH. The sample from the 2007 NSCH was comprised of 870 children with ASD, 16 772 CSHCN-ASD and 64 363 Non-CSHCN. The total sample included from the 2011-12 NSCH included 1624 children with ASD, 17 438 CSHCN-ASD, 66 420 Non-CSHCN. Initial univariate, bivariate and multivariate analyses were conducted with each data set using current ASD and CSHCN status as the primary independent variable of interests. The following health care quality variables used across surveys were the main dependent variables: insurance adequacy and medical home care receipt. All multivariate analyses were adjusted for socio-demographic factors. Cohort analyses were then used to compare the consistency of health care quality for children with ASD between 2007 and 2011 using the birth cohort of children with ASD age 2-13 years from the 2007 NSCH and children with ASD age 6-17 years from the 2011-12 NSCH.

Results: Across both samples of children age 2-17 years from the 2007 NSCH and 2011-12 NSCH, results revealed that children with ASD fared worse in terms of health care quality, specifically in terms of health insurance adequacy and medical home care, relative to both CSHCN and Non-CSHCN. The results from initial cohort analyses suggest that the quality of care received by US children with ASD compared to CSHCN and Non-CSHCN has remained relatively constant between 2007 and 2011.

Conclusion: Between 2007 and 2011 children with ASD remained less likely to receive minimal health care quality than CSHCN-ASD and Non-CSHCN. Consequently, ongoing efforts to improve the technical quality of health care for children with ASD are imperative to advancing care equity among US children.