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自闭症患儿与非自闭症患儿家长对健康状况及医疗保健利用情况的报告:全国儿童健康调查。

Parental report of health conditions and health care use among children with and without autism: National Survey of Children's Health.

作者信息

Gurney James G, McPheeters Melissa L, Davis Matthew M

机构信息

Child Health Evaluation and Research Unit, Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109-0456, USA.

出版信息

Arch Pediatr Adolesc Med. 2006 Aug;160(8):825-30. doi: 10.1001/archpedi.160.8.825.

Abstract

OBJECTIVE

To compare parent-reported prevalence of health conditions and health care use between children with and without autism.

DESIGN

Cross-sectional analysis of the 2003 to 2004 National Survey of Children's Health.

SETTING

Population-based sample across the United States.

PARTICIPANTS

More than 100 000 parents. The main exposure was "autism" (not further defined), from response to the question: "Has a doctor or health professional ever told you that your child has autism?"

MAIN OUTCOME MEASURES

Medical and mental health conditions and measures of health care use.

RESULTS

Autism prevalence among children aged 3 to 17 years was 53 per 10 000 (95% confidence interval, 45-61 per 10,000), equating to a national estimate of 324 000 children (95% confidence interval, 274,000-375,000 children). Children with autism had a significantly (P<.001) higher prevalence of depression or anxiety problems (38.9% vs 4.2%) and behavioral or conduct problems (58.9% vs 5.2%) than children without autism. Respiratory, food, and skin allergies were reported by parents more often for children with autism, with food allergies having the strongest relative difference between the groups (odds ratio, 4.5; 95% confidence interval, 3.0-7.0). Children with autism had significantly (P<.001) higher mean physician visits over 12 months for preventive care, nonemergency care, and hospital emergency care, and were far more likely than children without autism to receive physical, occupational, or speech therapy (76.0% vs 6.3%), to need treatment or counseling for an emotional, developmental, or behavioral problem (75.4% vs 7.0%), and, among those taking a prescribed medication, to be using a medication long-term (51.4% vs 14.5%).

CONCLUSION

We found markedly higher reports of concurrent conditions and health care use associated with childhood autism in this study.

摘要

目的

比较有自闭症和无自闭症儿童家长报告的健康状况患病率及医疗保健利用情况。

设计

对2003年至2004年全国儿童健康调查进行横断面分析。

背景

基于美国全人群的样本。

参与者

超过10万名家长。主要暴露因素为“自闭症”(未进一步明确),来自对以下问题的回答:“是否有医生或健康专业人员曾告诉你,你的孩子患有自闭症?”

主要结局指标

医疗和心理健康状况以及医疗保健利用指标。

结果

3至17岁儿童中自闭症患病率为每10000人中有53例(95%置信区间为每10000人中有45 - 61例),据此全国估计有324000名儿童(95%置信区间为274000 - 375000名儿童)。与无自闭症儿童相比,自闭症儿童患抑郁或焦虑问题(38.9%对4.2%)以及行为或品行问题(58.9%对5.2%)的患病率显著更高(P<0.001)。自闭症儿童的家长报告其孩子出现呼吸、食物和皮肤过敏的情况更为频繁,其中食物过敏在两组间的相对差异最为显著(优势比为4.5;95%置信区间为3.0 - 7.0)。自闭症儿童在12个月内接受预防性护理、非急诊护理和医院急诊护理的平均就诊次数显著更多(P<0.001),并且比无自闭症儿童更有可能接受物理治疗、职业治疗或言语治疗(76.0%对6.3%),因情绪、发育或行为问题而需要治疗或咨询的可能性也更高(75.4%对7.0%),在服用处方药的儿童中,长期用药的比例也更高(51.4%对14.5%)。

结论

在本研究中,我们发现与儿童自闭症相关的并发疾病报告以及医疗保健利用情况明显更高。

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