Comorbidity prevalence, healthcare utilization, and expenditures of Medicaid enrolled adults with autism spectrum disorders.
Rini Vohra, Suresh Madhavan, Usha Sambamoorthi
PMID 27875247WHAT IT FOUND
Medicaid adults with autism spectrum disorder had high psychiatric comorbidity, more outpatient visits, prescriptions, and spending, but less inpatient and emergency use than matched adults without autism.
Key findings
01Psychiatric comorbidity was much more common among adults with ASD than adults without ASD (81% vs 41%), and developmental disorders were the most common psychiatric comorbidity (70%).
02Adults with ASD had more outpatient visits and prescription claims per year (32 vs 8 and 51 vs 24) but lower inpatient and emergency use.
03Among adults with ASD, psychiatric comorbidity increased total spending by US$4952, and non-psychiatric comorbidity increased total spending by US$5084.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The study used only Medicaid fee-for-service claims from Illinois, New York, and Texas for 2000 to 2008. ASD and comorbidities were identified from claims codes and were not validated among adults. The study did not control for unobservable bias, and it did not match groups on enrollment period. Outcomes were all-cause visits and spending, so the study did not show why adults used services. Adults had to be continuously enrolled, which may exclude people with irregular Medicaid enrollment. Home and community-based waivers could not be identified.
The easy way to misread this
Do not read higher total Medicaid spending as evidence that adults with autism use more hospital or emergency care. In this claims study, adults with autism had lower inpatient and emergency use but higher outpatient visits and prescription claims.