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Sunday, October 23, 2016

Comorbidity

In The Politics of Autism, I discuss health care issues and state Medicaid services for people with intellectual and developmental disabilities.

At Autism, Rini Vohra, Suresh Madhavan, and Usha Sambamoorthi have an article title "Comorbidity Prevalence, Healthcare Utilization, and Expenditures of Medicaid Enrolled Adults with Autism Spectrum Disorders."  Using Medicaid data, they find:
Adults with autism spectrum disorders had significantly higher rates of psychiatric comorbidity (81%), epilepsy (22%), infections (22%), skin disorders (21%), and hearing impairments (18%). Adults with autism spectrum disorders had higher mean annual outpatient office visits (32ASD vs 8noASD) and prescription drug use claims (51ASD vs 24noASD) as well as higher mean annual outpatient office visits (US$4375ASD vs US$824noASD), emergency room (US$15,929ASD vs US$2598noASD), prescription drug use (US$6067ASD vs US$3144noASD), and total expenditures (US$13,700ASD vs US$8560noASD). The presence of a psychiatric and a non-psychiatric comorbidity among adults with autism spectrum disorders increased the annual total expenditures by US$4952 and US$5084, respectively.
From the study:
From a policy perspective, our study showed that adults with ASD represent a high needs group within the Medicaid population. Medicaid coverage provides substantial number of services for adults with ASD which also transforms into extremely high costs. With the recent efforts to reduce long term healthcare costs and still maintain quality care, understanding the pattern of healthcare utilization and factors influencing the high services use among adults with ASD draws attention to the need for better coordinated care and/or processes to improve communication and treatment experiences of this group.