Advertisement

Autism Prevalence in the Medicaid Program and Healthcare Utilization and Costs Among Adult Enrollees Diagnosed with Autism

  • Krutika Jariwala-ParikhEmail author
  • Marie Barnard
  • Erin R. Holmes
  • Donna West-Strum
  • John P. Bentley
  • Benjamin Banahan
  • Rahul Khanna
Original Article

Abstract

As the number of individuals diagnosed with autism increases, there is an increase in demand to provide support throughout their lifespan. This study aimed to: (1) estimate trends in the prevalence of autism diagnoses and medical services use in adults with autism diagnoses; (2) assess predictors of healthcare utilization and costs among adults with autism diagnoses enrolled in Medicaid. A retrospective analysis of 2006–2008 Medicaid claims for 39 states was conducted. There was a 38% increase in the prevalence of autism diagnoses from 2006 to 2008. Total expenditures and outpatient and ER visits varied significantly by demographic variables.

Keywords

Autism spectrum disorders Medicaid Prevalence Healthcare utilization Costs 

Notes

Funding

This study was part of a larger project funded by the Organization for Autism Research and a University of Mississippi Graduate School Council Research Grant. The study was presented as a poster at the 2014 Annual Research Meeting (ARM), AcademyHealth, June 8–10, San Diego, CA.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

References

  1. American Psychiatric Association. (2013). Diagnostic criteria for 299.00 Autistic Disorder. Diagnostic and Statistical Manual of Mental Disorders (5th ed ed.). Washington DC: American Psychiatric Association.CrossRefGoogle Scholar
  2. Boyle, C. A., Boulet, S., Schieve, L. A., Cohen, R. A., Blumberg, S. J., Yeargin-Allsopp, M., et al. (2011). Trends in the prevalence of developmental disabilities in US children, 1997–2008. Pediatrics, 127, 1034–1042.CrossRefGoogle Scholar
  3. Brugha, T. S., McManus, S., Bankart, J., Scott, F., Purdon, S., Smith, J., et al. (2011). Epidemiology of autism spectrum disorders in adults in the community in England. Archives of General Psychiatry, 68, 459–465.CrossRefGoogle Scholar
  4. Buck, T. R., Viskochil, J., Farley, M., Coon, H., McMahon, W. M., Morgan, J., et al. (2014). Psychiatric comorbidity and medication use in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 44, 3063–3071.CrossRefGoogle Scholar
  5. Buescher, A. V. S., Cidav, Z., Knapp, M., & Mandell, D. S. (2014). Costs of autism spectrum disorders in the United Kingdom and the United States. JAMA Pediatrics, 168(8), 721.CrossRefGoogle Scholar
  6. Cidav, Z., Lawer, L., Marcus, S. C., & Mandell, D. S. (2012). Age-related variation in health service use and associated expenditures among children with autism. Journal of Autism and Developmental Disorders, 43, 924–931.CrossRefGoogle Scholar
  7. Cimera, R. E., & Cowan, R. J. (2009). The costs of services and employment outcomes achieved by adults with autism in the US. Autism, 13, 285–302.CrossRefGoogle Scholar
  8. Croen, L. A., Najjar, D. V., Ray, G. T., Lotspeich, L., & Bernal, P. (2006). A comparison of health care utilization and costs of children with and without autism spectrum disorders in a large group-model health plan. Pediatrics, 118, e1203–e1211.CrossRefGoogle Scholar
  9. Deyo, R. A., Cherkin, D. C., & Ciol, M. A. (1992). Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology, 45, 613–619.CrossRefGoogle Scholar
  10. Fortuna, R. J., Robins, L., Smith, T. H., Meccarello, J., Bullen, B., Nobis, K., et al. (2015). Health conditions and functional status in adults with autism: A cross-sectional evaluation. Journal of General Internal Medicine, 31(1), 77–84.CrossRefGoogle Scholar
  11. Iannuzzi, D. A., Cheng, E. R., Broder-Fingert, S., & Bauman, M. L. (2014). Brief report: Emergency department utilization by individuals with autism. Journal of Autism and Developmental Disorders, 45, 1096–1102.CrossRefGoogle Scholar
  12. Kohane, I. S., McMurry, A., Weber, G., MacFadden, D., Rappaport, L., Kunkel, L., et al. (2012). The co-morbidity burden of children and young adults with autism spectrum disorders. PLoS ONE, 7(4), e33224–e33224.CrossRefGoogle Scholar
  13. Liptak, G. S., Stuart, T., & Auinger, P. (2006). Health care utilization and expenditures for children with autism: Data from U.S. national samples. Journal of Autism and Developmental Disorders, 36(7), 871–879.CrossRefGoogle Scholar
  14. Magana, S., Parish, S. L., Rose, R. A., Timberlake, M., & Swaine, J. G. (2012). Racial and ethnic disparities in quality of health care among children with autism and other developmental disabilities. Journal of Intellectual and Developmental Disability, 50, 287–299.CrossRefGoogle Scholar
  15. Mandell, D. S., Listerud, J., Levy, S. E., & Pinto-Martin, J. A. (2002). Race differences in the age at diagnosis among medicaid-eligible children with autism. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1447–1453.CrossRefGoogle Scholar
  16. Mandell, D. S., Wiggins, L. D., Carpenter, L. A., Daniels, J., DiGuiseppi, C., Durkin, M. S., et al. (2009). Racial/ethnic disparities in the identification of children with autism spectrum disorders. American Journal of Public Health, 99, 493–498.CrossRefGoogle Scholar
  17. Nicolaidis, C., Raymaker, D., McDonald, K., Dern, S., Boisclair, W. C., Ashkenazy, E., et al. (2012). Comparison of healthcare experiences in autistic and non-autistic adults: A cross-sectional online survey facilitated by an academic-community partnership. Journal of General Internal Medicine, 28, 761–769.CrossRefGoogle Scholar
  18. RUCA Data. (2013). Rural-urban commuting area codes (RUCAs). Retrieved June 9th, 2015, from www. http://depts.washington.edu/uwruca/.
  19. Shimabukuro, T. T., Grosse, S. D., & Rice, C. (2008). Medical expenditures for children with an autism spectrum disorder in a privately insured population. Journal of Autism and Developmental Disorders, 38(3), 546–552.CrossRefGoogle Scholar
  20. Wingate, M., Kirby, R. S., Pettygrove, S., Cunniff, C., Schulz, E., Ghosh, T., et al. (2014). Prevalence of autism spectrum disorder among children aged 8 years-autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveillance Summaries, 63, 1–21.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Pharmacy AdministrationUniversity of MississippiUniversityUSA
  2. 2.Department of Pharmacy Administration and Center for Pharmaceutical Marketing and ManagementUniversity of MississippiUniversityUSA
  3. 3.Life Sciences, IBM Watson HealthAnn ArborUSA
  4. 4.Real World Data Analytics and Research, Epidemiology, Medical DevicesJohnson & Johnson Co.New BrunswickUSA

Personalised recommendations