Structure, Use & Expenditures for Autism Services

描述(由申请人提供)：这项研究旨在开发一种服务研究方法，以了解自闭症的护理和治疗的结构、利用和支出。这项为期三年的研究将与北卡罗来纳大学TEAACH分部一起进行，由几个部分组成。首先，将根据文献综述、关键线人访谈和焦点小组制定一个概念和分析框架，以确定自闭症儿童家庭获得的正式和非正式服务。第二，将利用医疗支出小组调查(MEPS)和其他服务利用工具制定电话调查方案。第三，电话调查将在北卡罗来纳州进行，抽样对象为三个年龄段(3岁以下、3-5岁和6-8岁)中有自闭症儿童的家庭(N=480)。(每层约160例)。将抽取样本，以捕捉目标人群的地理、社会经济和诊断分布的变化。第四，将利用对调查数据的分析，结合从选定的服务提供者那里获得的信息(通过国家会议上的重点小组)，设计一份R01申请，以便在03--赠款年度初期提交。该应用程序将建议对家庭和提供者的关联样本进行服务利用的多站点研究(N=6-8个站点)，以开发有关各种服务和社区环境的使用和支出(包括自付和第三方)的综合信息。第五，除了多点研究外，该项目中开展的工作将有助于全大学努力制定关于自闭症干预和服务研究的研究计划。 这项申请使用R21机制，因为一个成熟的研究团队正在将其工作扩展到一个新的领域--从精神健康服务和特殊教育到自闭症--也因为这项初步研究将开发数据，将在此基础上进行重要的未来研究。这项工作将向临床研究人员和政策制定者提供关于使用哪些治疗方法、由谁使用、以什么组合使用以及在什么情况下使用的基本信息。这项研究可以为新疗法的临床试验和未来的示范项目提供信息，因为我们将能够展示当前的使用模式，这可能涉及多种医疗、教育和行为疗法，以及补充和替代疗法的使用。

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.