Health care access and treatment for children with co-morbid autism and psychiatric conditions
Health care access and treatment for children with co-morbid autism and psychiatric conditions
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DOI：
10.1007/s00127-012-0482-0
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发表时间：
2012-11-01
影响因子：
4.4
通讯作者：
Hock, Robert M.
中科院分区：
文献类型：
--
作者：
Ahmedani, Brian K.;Hock, Robert M.
为了描述自闭症谱系障碍（ASD）儿童中共病精神疾病（CPC）的发生率，检查其治疗利用情况，并调查治疗延迟或未交付，使用2007-2008年全国儿童健康调查（NSCH）的数据对2-17岁儿童的终身ASD和CPC进行了调查。NSCH调查了父母和监护人关于18岁以下儿童的健康和福祉，包括治疗（n = 91，642）。有健康状况的儿童是由父母报告医生或其他健康专业人员曾说他们的孩子有这种状况来定义的。与整体健康，治疗利用率，和访问变量的障碍相关的因素进行了调查，在这group.Children ASD/CPC有较差的整体健康结果比单独ASD的儿童。他们更经常不满意他们的供应商之间的沟通，很少有保险覆盖所需的服务。尽管如此，他们确实倾向于在更大程度上使用护理协调和心理健康服务。家庭更有可能报告延迟或未收到所需的服务时，他们认为缺乏沟通和合作伙伴关系与供应商，当他们缺乏保险覆盖面，当他们觉得医疗保健费用是不合理的。正因为如此，与自闭症儿童一起工作的卫生专业人员应该特别关注那些患有共病诊断的儿童的治疗。
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.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.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.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.