Lurie Institute for Disability Policy (Shields, Akobirshoev, Dembo, Mitra) and Institute for Behavioral Health (Shields), Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts.
Psychiatr Serv. 2019 Jun 1;70(6):457-464. doi: 10.1176/appi.ps.201800318. Epub 2019 Mar 7.
Research on hospitalizations related to self-injurious behavior and ideation among adults with autism spectrum disorder (ASD) is limited. This study compared admissions, average length of stay, and costs of resources to deliver care for such hospitalizations between adults with and without ASD.
The 2014 Healthcare Cost and Utilization Project National Inpatient Sample was used to compare 5,341 discharge records for adults with ASD and 16,023 records for adults without ASD, matched on age and gender in a 1:3 ratio. Hierarchical logistic and linear regressions accounted for clustering by hospital. Covariates included gender, race-ethnicity, age, region, comorbidities, number of procedures, and insurance.
Among hospitalized adults, those with ASD were twice as likely as those without ASD to have a hospitalization related to self-injurious behavior and ideation. Among hospital stays for self-injurious behavior and ideation, adults with ASD had average lengths of stay that were 2.14 days longer (95% confidence interval [CI]=1.20-3.08) compared with adults without ASD. Among adults with a hospitalization related to self-injurious behavior and ideation, unadjusted average costs for those with ASD were 36.8% higher than for adults without ASD. After the analysis accounted for covariates and length of stay, adults with ASD still had 7.48% (95% CI=1.05%-14.32%) higher costs.
Adults with ASD were twice as likely as adults without ASD to have a hospitalization related to self-injurious behavior and ideation. Among adults with such a hospitalization, those with ASD had longer stays and, even after the analysis accounted for length of stay, higher costs.
针对自闭症谱系障碍（ASD）成人的自伤行为和观念相关住院治疗的研究有限。本研究比较了 ASD 成人和非 ASD 成人的住院人数、平均住院时间和提供此类住院治疗资源的成本。
使用 2014 年医疗保健成本和利用项目国家住院患者样本，按年龄和性别 1:3 比例匹配，比较了 5341 例 ASD 成人出院记录和 16023 例非 ASD 成人记录。通过医院进行分层逻辑回归和线性回归。协变量包括性别、种族-民族、年龄、地区、合并症、手术次数和保险。
在住院成人中，患有 ASD 的人发生与自伤行为和观念相关的住院治疗的可能性是没有 ASD 的人的两倍。在与自伤行为和观念相关的住院治疗中，与非 ASD 成人相比，ASD 成人的平均住院时间长 2.14 天（95%置信区间[CI]=1.20-3.08）。在与自伤行为和观念相关的住院治疗的成人中，未经调整的 ASD 成人的平均费用比非 ASD 成人高 36.8%。在分析了协变量和住院时间后，ASD 成人的费用仍然高出 7.48%（95% CI=1.05%-14.32%）。
患有 ASD 的成人发生与自伤行为和观念相关的住院治疗的可能性是没有 ASD 的成人的两倍。在有此类住院治疗的成人中，ASD 成人的住院时间更长，即使在分析了住院时间后，他们的费用也更高。
