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Gepubliceerd in:

17-04-2021 | Original Paper

Service Use Among Transition-Age Youth with Autism Spectrum Disorder

Auteurs: Karen J. Ishler, David E. Biegel, Fei Wang, Tugba Olgac, Sarah Lytle, Stacy Miner, Marjorie Edguer, Ronna Kaplan

Gepubliceerd in: Journal of Autism and Developmental Disorders | Uitgave 3/2022

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Abstract

This study explored predictors of service use among 174 transition-age youth (age 16–30) with an Autism Spectrum Disorder using Andersen’s (J Health Soc Behav 36(1):1–10, 1995) healthcare utilization model. Family caregivers were interviewed about past 6-month use of 15 services. On average, youth used 6.1 and needed 3.2 additional services. Greater service use was associated with two predisposing (caregiver college educated, caregiver not married/partnered), two enabling (youth has Medicaid waiver, youth in high school), and one need factor (lower adaptive functioning). Use of specific services was most strongly related to enabling (Medicaid waiver, in high school) and need factors (lower adaptive functioning, comorbid mental health diagnosis). Findings provide a snapshot of the “service cliff” faced by families and highlight the need for additional research.
Voetnoten
1
Although this score is typically subtracted from 100 to yield an index that becomes more negative with greater levels of maladaptive behavior, the original summary score was used to simplify interpretation.
 
2
Although number of services is technically a discrete count, OLS regression was justified on the basis that: (a) Values in the sample extended the full range (0-15) and were approximately normally distributed (M = 6.13, SD = 3.23, skewness = 0.27, kurtosis = -0.53); (b) predicted values generated using the final model were approximately normally distributed (M = 6.13, SD = 2.05, skewness = 0.29, kurtosis = 0.63), did not extend beyond the range of possible values, and did not include negative values (range = 1.96 to 11.72); and (c) model residuals were normally distributed and no influential outliers were detected (leverage values all < .20). A sensitivity analysis was conducted to evaluate the potential for bias resulting from the use of OLS. A logistic regression model with aggregated data was determined to be the most appropriate alternative model. In such a model, each of the 15 services is regarded as a trial, the number of trials is fixed, the trials are independent, and the probability of “success” (i.e., use) is the same for each service. The model estimates the effect of each predictor on the odds of using an additional service.
 
Literatuur
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go back to reference Jariwala-Parikh, K., Barnard, M., Holmes, E. R., West-Strum, D., Bentley, J. P., Banahan, B., & Khanna, R. (2019). Autism prevalence in the Medicaid program and healthcare utilization and costs among adult enrollees diagnosed with autism. Administration and Policy in Mental Health and Mental Health Services Research, 46(6), 768–776. https://doi.org/10.1007/s10488-019-00960-z.CrossRefPubMed Jariwala-Parikh, K., Barnard, M., Holmes, E. R., West-Strum, D., Bentley, J. P., Banahan, B., & Khanna, R. (2019). Autism prevalence in the Medicaid program and healthcare utilization and costs among adult enrollees diagnosed with autism. Administration and Policy in Mental Health and Mental Health Services Research, 46(6), 768–776. https://​doi.​org/​10.​1007/​s10488-019-00960-z.CrossRefPubMed
go back to reference Schulz, R., Burgio, L., Burns, R., Eisdorfer, C., Gallagher-Thompson, D., Gitlin, L. N., & Mahoney, D. F. (2003). Resources for enhancing Alzheimer’s caregiver health (REACH): Overview, site-specific outcomes, and future directions. The Gerontologist, 43(4), 514–520.CrossRef Schulz, R., Burgio, L., Burns, R., Eisdorfer, C., Gallagher-Thompson, D., Gitlin, L. N., & Mahoney, D. F. (2003). Resources for enhancing Alzheimer’s caregiver health (REACH): Overview, site-specific outcomes, and future directions. The Gerontologist, 43(4), 514–520.CrossRef
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Metagegevens
Titel
Service Use Among Transition-Age Youth with Autism Spectrum Disorder
Auteurs
Karen J. Ishler
David E. Biegel
Fei Wang
Tugba Olgac
Sarah Lytle
Stacy Miner
Marjorie Edguer
Ronna Kaplan
Publicatiedatum
17-04-2021
Uitgeverij
Springer US
Gepubliceerd in
Journal of Autism and Developmental Disorders / Uitgave 3/2022
Print ISSN: 0162-3257
Elektronisch ISSN: 1573-3432
DOI
https://doi.org/10.1007/s10803-021-04999-6