Structure, Use & Expenditures for Autism Services

描述（由申请人提供）：本研究旨在发展一种服务研究方法，以了解自闭症护理和治疗的结构、利用和支出。这项为期三年的研究将与北卡罗来纳大学（University of North Carolina）的Division TEAACH联合进行，它有几个组成部分。首先，将从文献综合、关键信息提供者访谈和焦点小组中制定一个概念性和分析性框架，以确定有自闭症儿童的家庭获得的正式和非正式服务。第二，将根据医疗支出小组调查（MEPS）和其他服务利用工具制定电话调查协议。第三，电话调查将在北卡罗莱纳进行，调查对象是有自闭症儿童的家庭（N= 480），他们来自三个年龄组（小于3岁）中的一个。3-5年。6-8岁。（每层约160例）。将抽取样本以捕捉目标人群在地理、社会经济和诊断分布方面的变化。第四，将对调查数据进行分析，并结合从选定的服务提供商（通过全国会议上的焦点小组）获得的信息，设计一份R01申请，以便在03拨款年度早期提交。本申请将提出一项服务利用的多地点研究（N= 6-8个地点），用于家庭和提供者的关联样本，以开发关于各种服务和社区环境的利用和支出（包括自付和第三方）的综合信息。第五，除了多地点研究外，本项目的工作将有助于全校范围内开展自闭症干预和服务研究的研究项目。

DESCRIPTION (provided by applicant): This research study seeks to develop a services research approach to understanding the structure, utilization, and expenditures for the care and treatment of autism. The three-year study, which will be carried out in conjunction with Division TEAACH at the University of North Carolina, has several components. First, a conceptual and analytical framework for identifying the formal and informal services accessed by families with autistic children will be developed from literature syntheses, key informant interviews, and focus groups. Second, a telephone survey protocol will be developed drawing upon the Medical Expenditure Panel Survey (MEPS) and other service utilization instruments. Third, the telephone survey will be fielded in North Carolina with a sample of families with an autistic child (N= 480) in one of three age groups (less than 3 yrs., 3-5 yrs., and 6-8 yrs. (about 160 cases in each strata). The sample will be drawn to capture variations in the geographic, socioeconomic, and diagnostic distribution of the target population. Fourth, the analysis of survey data in conjunction with information obtained from selected service providers (via focus groups at national meetings) will be used to design an R01 application for submission early in the 03-grant year. This application will propose a multi-site study (N= 6-8 sites) of service utilization for a linked sample of families and providers to develop comprehensive information about utilization and expenditures (both out-of-pocket and third-party) for a diverse array of services and community settings. Fifth, in addition to the multi-site study, the work carried out in this project will contribute to University-wide efforts to develop a research program on interventions and services research on autism. This application uses the R21 mechanism because an established research team is extending its work into a new area-from mental health services and special education into autism-and because this initial research will develop data upon which significant future research will be built. This work will provide basic information to clinical researchers and policymakers regarding which treatments are utilized, by whom, in what combinations, and under what circumstances. This research can inform clinical trials and future demonstration projects of new treatments since we will be able to demonstrate the current utilization patterns, which may involve multiple medical, educational, and behavioral treatments, as well as use of complementary and alternative treatments.