Nathenson Robert A, Zablotsky Benjamin
Dr. Nathenson is with the Leonard Davis Institute of Health Economics, Wharton School of the University of Pennsylvania, Philadelphia. Dr. Zablotsky is with the Division of Health Interview Statistics, National Center for Health Statistics, Hyattsville, Maryland. Send correspondence to Dr. Zablotsky (e-mail:
Psychiatr Serv. 2017 Jul 1;68(7):735-738. doi: 10.1176/appi.ps.201600239. Epub 2017 Mar 15.
The study examined how health care utilization patterns among youths with autism spectrum disorder (ASD) change as they transition into the adult health care system.
Data came from the Clinformatics Data Mart Database, a nationally diverse, clinically rich, private insurance claims database. The analytic sample consisted of youths ages 16 to 23 who were diagnosed as having ASD (N=16,338). Cross-sectional multivariate linear regressions determined whether service usage in home, office or outpatient, inpatient, and emergency department (ED) settings differed by age.
The proportion of youths with ASD who received services declined with age in each setting except the ED. A similar reduction existed in number of visits to office or outpatient settings and inpatient settings, while home and ED visits remained stable. Service utilization declined faster among youths with co-occurring intellectual disability.
There is a notable decline in service utilization across multiple settings as youths with ASD transition from pediatric to adult health care.
本研究探讨了自闭症谱系障碍（ASD）青年在过渡到成人医疗保健系统时，其医疗保健利用模式是如何变化的。
数据来自临床信息数据集市数据库，这是一个具有全国多样性、临床信息丰富的私人保险理赔数据库。分析样本包括16至23岁被诊断为患有ASD的青年（N = 16338）。横断面多元线性回归确定了在家庭、办公室或门诊、住院和急诊科环境中的服务使用情况是否因年龄而异。
除急诊科外，在每个环境中，接受服务的ASD青年比例均随年龄下降。在办公室或门诊环境以及住院环境中的就诊次数也有类似的减少，而家庭和急诊科就诊次数保持稳定。伴有智力残疾的青年的服务利用率下降得更快。
随着患有ASD的青年从儿科医疗保健过渡到成人医疗保健，多种环境下的服务利用率显著下降。
