Mental health hospitalizations and follow-up care in autistic adults

项目摘要 自闭症成年人的心理健康状况比同龄人更高， 生活质量和增加的复杂性和医疗保健的成本。经历逆境，孤立， 污名化可能会增加自闭症患者的心理健康风险。心理健康服务可以发挥 在支持人们科普心理健康问题方面发挥关键作用。当心理健康不足以 问题经常升级到危机水平，可治疗的心理健康状况变得更加严重 并随着时间而失效。虽然美国没有集中的精神健康危机系统，紧急 住院治疗是许多人危机护理的一个组成部分。对以下方面的了解有限： 住院治疗的自闭症成年人，但初步研究结果表明，精神健康状况，包括情绪 精神障碍和精神分裂症是自闭症成年人住院治疗的最常见原因。 虽然医院是心理健康紧急和危机护理的常见来源，但它们往往没有配备 提供优质护理。这是一个在自闭症患者中被放大的问题，因为缺乏提供者的知识， 自闭症、多种并发症的高患病率以及使护理复杂化的自闭症特征 包括感官敏感性和对新习惯和未知地方的困难。因此，立即护理 住院治疗是解决危机和努力实现维持护理的一个重要部分。 没有接受适当后续护理的人更有可能停止护理并经历住院 再入院、服务和药物治疗不依从性以及自我伤害和危险行为。因为 住院治疗对成年自闭症患者来说可能特别痛苦，适当的后续护理至关重要。 对自闭症成年人的精神卫生保健知之甚少，包括住院治疗和后续护理 在精神病住院治疗后但是，有限的供应商可用性，缺乏供应商知识， 孤立的服务系统表明，护理可以得到极大的改善。本研究的目的是探讨 与其他成年人相比，自闭症成年人的精神健康住院和危机后的护理模式 因精神疾病住院治疗我们将使用两个全国性的数据来源来做这件事：一个全付费医院， 再入院数据库和医疗补助申请使用全国所有支付者住院数据可以实现一个完整的 经验的图片，以告知改善，而重点是医疗补助索赔允许一个完整的调查 随访护理服务使用和再入院的模式和预测因素。最终目标是提供信息服务 提供系统的变化，提高护理的适当性和改善自闭症成年人的生活质量。

PROJECT ABSTRACT Autistic adults experience higher rates of co-occurring mental health conditions than their peers, impacting quality of life and increasing the complexity and cost of health care. Experiences of adversity, isolation, and stigma may place autistic people at increased risk for mental health concerns. Mental health services can play a key role in supporting people to cope with mental health concerns. When mental health is not adequately addressed, issues frequently escalate to crisis level and treatable mental health conditions become more severe and disabling over time. While there is no centralized system mental health crisis system in the U.S., emergency and inpatient hospitalization is an integral part of crisis care for many people. There is limited understanding of hospitalization in autistic adults, but preliminary findings suggest mental health conditions, including mood disorders and schizophrenia, are among the most common reasons for inpatient hospitalization in autistic adults. While hospitals are a common source of emergency and crisis care for mental health, they are often not equipped to provide quality care. This is a problem amplified in autistic patients because of lack of provider knowledge of autism, high prevalence of multiple co-occurring conditions, and autism characteristics complicating care including sensory sensitivity and difficulty with new routines and unknown places. Therefore, care immediately following hospitalization is an important part of addressing the crisis and working towards maintenance care. People who do not receive appropriate follow-up care are more likely to cease care and experience hospital readmissions, service and medication non-compliance, and self-injurious and dangerous behaviors. Because hospitalization may be particularly traumatic for autistic adults, appropriate follow-up care is vitally important. Very little is known about mental health care in autistic adults, including hospitalization for and follow-up care after mental health hospitalization. But the picture of limited provider availability, lack of provider knowledge, and siloed service systems suggest that care can be vastly improved. The purpose of this study is to examine the mental health hospitalizations of autistic adults and the care patterns following crisis compared to other adults hospitalized for mental health conditions. We will do this using two national sources of data: an all-payer hospital readmissions database and Medicaid claims. Using national all-payer hospitalization data allows a complete picture of experiences to inform improvement, while focusing on Medicaid claims allows a complete investigation of patterns and predictors of follow-up care service use and readmission. The ultimate goal is to inform service delivery system changes that increase care appropriateness and improve quality of life in autistic adults.