Health care access and treatment for children with co-morbid autism and psychiatric conditions.
OBJECTIVE
To characterize the rate of comorbid psychiatric conditions (CPC) among children with autism spectrum disorders (ASD), to examine their treatment utilization, and to investigate treatment delay or non-delivery.


METHODS
Lifetime ASD and CPC in children, aged 2-17, were investigated using data from the 2007-2008 National Survey of Children's Health (NSCH). The NSCH surveyed parents and guardians regarding the health and well being, including treatment, of their child(ren) under age 18 (n = 91,642). Children with health conditions were defined by parent report that a doctor or other health professional had ever said their child had that condition. Factors related to overall health, treatment utilization, and barriers to access variables were investigated among this group.


RESULTS
Children with ASD/CPC had poorer overall health outcomes than children with ASD alone. They more often were dissatisfied with their between-provider communication and less often had insurance cover needed services. Nonetheless, they did tend to use care coordination and mental health services to a greater degree. Families were more likely to report the delay or non-receipt of needed services when they perceived a lack of communication and partnership with providers, when they lacked insurance coverage, and when they felt that health care costs were unreasonable.


CONCLUSIONS
The presence of a CPC seems to shape the treatment utilization and health outcomes of children with ASD. Because of this, health professionals working with children with autism should give special attention to treatment of those with comorbid diagnoses.
Center for Health Policy and Health Services Research, Henry Ford Health System, One Ford Place-3A, Detroit, MI 48202, USA. bahmeda1@hfhs.org
Brian K
BK
Ahmedani
Robert M
RM
Hock
D000293:Adolescent; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D002662:Child Health Services / Q000706:statistics & numerical data*; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D019458:Insurance Coverage; D007348:Insurance, Health; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data; D010290:Parents; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012959:Socioeconomic Factors