title: A Rural-Urban Comparison in Emergency Department Visits for U.S. Children with Autism Spectrum Disorder.
abstract: We examined rural-urban differences in emergency department visits, and child and clinical characteristics associated with visits for U.S. children aged 3-17 years with autism spectrum disorder (ASD). Rural children with ASD were twice more likely to have emergency department visits in urban hospitals than rural children without ASD. The children with ASD in rural areas were economically disadvantaged and concentrated in the South and Midwest regions. Rural children diagnosed with ASD and multiple comorbidities during emergency department visits were 1.6 times as that of urban children. Rural children with ASD, particularly those with multiple comorbidities, require more emergency department services when compared with urban children with ASD.
authors.affiliation: Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC, 27599-7122, USA. wanqing_zhang@med.unc.edu.
authors.forename: Wanqing
authors.identifier: 0000-0003-0291-4925
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC, 27599-7122, USA.
authors.forename: Ashley E
authors.initials: AE
authors.lastname: Mason
authors.affiliation: Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC, 27599-7122, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Boyd
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA.
authors.forename: Linmarie
authors.initials: L
authors.lastname: Sikich
authors.affiliation: Department of Allied Health Sciences, School of Medicine, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC, 27599-7122, USA.
authors.forename: Grace
authors.initials: G
authors.lastname: Baranek
mesh_terms: D000293:Adolescent; D000067877:Autism Spectrum Disorder / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012424:Rural Population / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*
keywords: Autism spectrum disorder (ASD); Emergency department visits; Rural–urban differences; Utilization of health services