Do Access Barriers to Autism Care Persist Despite Autism Insurance Mandate?

尽管有自闭症保险规定，获得自闭症护理的障碍是否仍然存在？

• 批准号: 8439498
• 负责人: Li Wang
• 金额: $ 29.54万
• 依托单位: PENNSYLVANIA STATE UNIV HERSHEY MED CTR
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-12 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8439498
• 关键词: Address; Affect; Area; Autistic Disorder; Behavior; Caring; Child; Child Care; Data; Databases; Eligibility Determination; Employee Retirement Income Security Act; Family; Future; Geographic Locations; Health Benefit; Health Policy; Home environment; Hospitals; Insurance; Insurance Carriers; Insurance Coverage; Knowledge; Lead; Life; Measures; Medical; Mental Health; Neurologic; Outpatients; Parents; Policies; Prevalence; Process; Provider; Relative (related person); Research; Resources; Services; Siblings; Single Parent; Statutes and Laws; Time; Training; Travel; United States; Visit; autism spectrum disorder; autistic children; base; cost; design; developmental disease; flexibility; improved; innovation; meetings; prevent; prospective; rural area; urban area

DESCRIPTION (provided by applicant): Autism spectrum disorder (ASD) is a neurological developmental disorder that affected approximately 1 in 110 children in the United States in 2006, and its prevalence has risen rapidly in recent years. In view of increasingly unmet needs for autism care, more and more states have passed mandates requiring private insurers to provide autism insurance. However, little is known about actual changes in autism services use, costs and health benefits after such mandates take effect. More importantly, access barriers to autism care persist for privately insured autistic children despite autism mandates. Without timely study and informed policy measures to address persistent access barriers, the care of children with ASD may be jeopardized. Using a unique large multi-state private insurance claims database, this research will be: 1) the first study to use post- mandate private insurance claims data to measure actual changes in autism service use, costs and health benefits after autism insurance mandates; and 2) the first study to explore access barriers that persist despite autism mandates. The findings will: 1) help evaluate autism mandates based on actual changes rather than prospective projections; and 2) help decision makers design future autism mandates and identify the next essential steps following the passage of autism insurance mandates to further remove access barriers and better serve children with ASD. PUBLIC HEALTH RELEVANCE: Access barriers to treatment care of Autism Spectrum Disorders (ASD) persist despite autism insurance mandates in more and more states that require private insurers to provide autism care coverage. Using a large, unique multi-state private insurance claims database, this research will be 1) the first study to use nation-wide post-mandate private insurance claims data to measure actual (rather than projected) changes in autism services use, costs and health benefits after the mandate; and 2) the first study to explore access barriers that persist despite autism insurance mandates. Findings from this study will 1) help evaluate autism mandates and design future autism mandates, and 2) help decision makers identify the next essential steps following insurance mandate enactment to further remove access barriers and better serve children with ASD.

描述（由申请人提供）：自闭症谱系障碍（ASD）是一种神经发育障碍，2006年在美国影响约1/110的儿童，近年来其患病率迅速上升。鉴于自闭症护理的需求越来越得不到满足，越来越多的州通过了要求私人保险公司提供自闭症保险的规定。然而，人们对这些规定生效后自闭症服务使用、成本和健康效益的实际变化知之甚少。更重要的是，尽管有自闭症的规定，但私人保险的自闭症儿童获得自闭症护理的障碍仍然存在。如果没有及时的研究和知情的政策措施来解决持续存在的障碍，自闭症儿童的护理可能会受到危害。使用一个独特的大型多州私人保险索赔数据库，这项研究将是：1）第一项使用授权后私人保险索赔数据来衡量自闭症保险授权后自闭症服务使用，成本和健康福利的实际变化的研究;和2）第一项研究探索尽管自闭症授权，但仍然存在的访问障碍。调查结果将：1）帮助评估基于实际变化而不是前瞻性预测的自闭症授权; 2）帮助决策者设计未来的自闭症授权，并确定自闭症保险授权通过后的下一步基本步骤，以进一步消除准入障碍，更好地为自闭症儿童服务。 公共卫生关系：尽管越来越多的州要求私人保险公司提供自闭症护理保险，但自闭症谱系障碍（ASD）治疗护理的准入障碍仍然存在。使用一个大型的，独特的多州私人保险索赔数据库，这项研究将是1）第一项研究使用全国范围内的授权后私人保险索赔数据来衡量授权后自闭症服务使用，成本和健康福利的实际（而不是预测）变化;和2）第一项研究探索尽管自闭症保险授权，但仍然存在的访问障碍。这项研究的结果将1）帮助评估自闭症授权和设计未来的自闭症授权，2）帮助决策者确定保险授权颁布后的下一个重要步骤，以进一步消除准入障碍，更好地为ASD儿童服务。