Characteristics of psychiatric emergency department use among privately insured adolescents with autism spectrum disorder
Characteristics of psychiatric emergency department use among privately insured adolescents with autism spectrum disorder
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DOI：
10.1177/1362361317749951
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发表时间：
2019-04-01
期刊：
影响因子：
5.2
通讯作者：
Vasa, Roma A.
中科院分区：
文献类型：
--
作者：
Kalb, Luther G.;Stuart, Elizabeth A.;Vasa, Roma A.
本研究调查了患有自闭症谱系障碍的青少年、患有注意缺陷多动障碍的青少年和没有自闭症谱系障碍或注意缺陷多动障碍的青少年之间精神病相关急诊就诊率的差异。其他结果包括急诊科累犯，急诊科就诊后精神病住院的概率，以及急诊科就诊前后接受门诊心理健康服务的情况。数据来自2010-2013年MarketScan商业索赔数据库中登记的12-17岁的私人保险青少年，患有自闭症谱系障碍（N = 46，323），注意缺陷多动障碍（N = 408，066）和两种诊断（N = 2，330，332）。与注意缺陷多动障碍青少年（IRR = 2.0，95%置信区间：1.9，2.1）和未诊断青少年（IRR = 9.9，95%置信区间：9.4，10.4）相比，自闭症谱系障碍青少年的精神科急诊就诊率增加。与其他组相比，患有自闭症谱系障碍的青少年在急诊科复发、急诊科就诊后精神病住院以及就诊前后接受门诊治疗的概率也增加（所有p < 0.001）。需要进一步的研究来了解这些发现是否适用于患有其他神经发育障碍的青少年，特别是那些有公共保险的青少年。
This study examined differences in the rates of psychiatric-related emergency department visits among adolescents with autism spectrum disorder, adolescents with attention deficit hyperactivity disorder, and adolescents without autism spectrum disorder or attention deficit hyperactivity disorder. Additional outcomes included emergency department recidivism, probability of psychiatric hospitalization after the emergency department visit, and receipt of outpatient mental health services before and after the emergency department visit. Data came from privately insured adolescents, aged 12-17 years, with autism spectrum disorder (N = 46,323), attention deficit hyperactivity disorder (N = 408,066), and neither diagnosis (N = 2,330,332), enrolled in the 2010-2013 MarketScan Commercial Claims Database. Adolescents with autism spectrum disorder had an increased rate of psychiatric emergency department visits compared to adolescents with attention deficit hyperactivity disorder (IRR = 2.0, 95% confidence interval: 1.9, 2.1) and adolescents with neither diagnosis (IRR = 9.9, 95% confidence interval: 9.4, 10.4). Compared to the other groups, adolescents with autism spectrum disorder also had an increased probability of emergency department recidivism, psychiatric hospitalization after the emergency department visit, and receipt of outpatient care before and after the visit (all p < 0.001). Further research is required to understand whether these findings extend to youth with other neurodevelopmental disorders, particularly those who are publicly insured.