Zhang Wanqing, Thompson Kelsey L
Department of Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Division of Speech and Hearing Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Children (Basel). 2022 Jul 21;9(7):1094. doi: 10.3390/children9071094.
Epilepsy is a common comorbidity among children with autism spectrum disorder (ASD). There is a lack of understanding of the inequality in access to care for children with co-occurring ASD and epilepsy (ASD-EP). The purpose of this study is to examine key indicators for access to care and care coordination for children with ASD-EP in the US National Survey of Children's Health (NSCH). Data were collected from the 2017-2019 NSCH. Our analytic sample included children with ASD without epilepsy (N = 2150), children with both ASD and epilepsy (N = 143), and children with epilepsy without ASD (N = 711). The dependent variables included important access to care indicators such as having usual sources of care, having adequate coverage, being frustrated in efforts to get service, and receiving care coordination. The independent variables included ASD-EP status, child demographics, and an intellectual disability (ID) diagnosis. Our results show that demographic characteristics such as sex, race, income level, and insurance type affect access to care. Inadequate access to healthcare was significantly higher among female children, children from low-income families, and children with ID. The access barriers among children with ASD-EP were more likely due to the interplay of multiple clinical and individual factors.
癫痫是自闭症谱系障碍(ASD)儿童中常见的共病情况。对于同时患有ASD和癫痫(ASD-EP)的儿童在获得医疗服务方面存在的不平等现象,人们缺乏了解。本研究的目的是在美国儿童健康全国调查(NSCH)中,考察ASD-EP儿童获得医疗服务和医疗协调的关键指标。数据收集自2017 - 2019年的NSCH。我们的分析样本包括无癫痫的ASD儿童(N = 2150)、同时患有ASD和癫痫的儿童(N = 143)以及无ASD的癫痫儿童(N = 711)。因变量包括获得医疗服务的重要指标,如拥有常规医疗服务来源、有足够的保险覆盖、在获取服务的努力中感到沮丧以及接受医疗协调。自变量包括ASD-EP状态、儿童人口统计学特征以及智力残疾(ID)诊断。我们的结果表明,性别、种族、收入水平和保险类型等人口统计学特征会影响获得医疗服务的情况。女童、低收入家庭儿童和患有ID的儿童在获得医疗保健方面存在不足的比例显著更高。ASD-EP儿童的就医障碍更可能是多种临床和个体因素相互作用的结果。