Health service utilization among autistic youth in Aotearoa New Zealand: A nationwide cross-sectional study.
Laurie K McLay, Philip J Schluter, John Williams and 10 others
PMID 39625166WHAT IT FOUND
Autistic youth in New Zealand used mental health services, psychotropic medication and hospital care at much higher rates than matched non-autistic peers, but used accident compensation services less.
Those with intellectual disability had even higher non-psychiatric hospital use.
Key findings
01Autistic youth had substantially higher rates of mental health service use, including psychiatric inpatient admissions, outpatient visits and psychotropic medication dispensing, compared with matched non-autistic youth.
02Rates of Accident Compensation Corporation (ACC) claims were lower among autistic youth compared with non-autistic youth, unlike other healthcare services.
03Autistic youth with co-occurring intellectual disability had higher prevalence ratios for non-psychiatric hospitalizations and potentially avoidable hospitalizations than autistic youth without intellectual disability.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The method for identifying autism relies on recorded diagnoses in specific datasets and has not been validated, likely undercounting true prevalence, especially among marginalized groups. Health service use was dichotomized, so the study does not capture the frequency or intensity of service use, underestimating the total burden. Data on primary care visits and private healthcare were not available, limiting the view of total healthcare utilization. Matching controlled for sociodemographics but not for age at diagnosis, co-occurring conditions or familial factors, which could influence service use.
Declared interests
The authors declared no conflicts of interest. Funding was provided by the Laura Fergusson Trust and Joyce Fisher Endowment Fund Trust, which had no role in study design, data collection, analysis or manuscript preparation.
The easy way to misread this
Do not assume that higher service use means better care or outcomes. The lower rates of accident compensation claims and high rates of potentially avoidable hospitalizations suggest that autistic youth, especially those with intellectual disability, may be facing barriers to accessing preventive or appropriate support, leading to crisis-driven care.