Interstate Variation in Healthcare Utilization Among Children with ASD

自闭症谱系障碍儿童医疗保健利用的州际差异

• 批准号: 7871015
• 负责人: David S Mandell
• 金额: $ 17.19万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7871015
• 关键词: Address; Administrator; Affect; Area; Autistic Disorder; Caring; Censuses; Characteristics; Child; Child Care; Chronic; Clinical; Code; Cost Sharing; Data; Decision Making; Developmental Disabilities; Diagnosis; Eligibility Determination; Expenditure; Family; Funding; Future; Health; Health Services; Healthcare; Healthcare Systems; Human; Income; Individual; Intervention; Interview; Lead; Link; Longevity; Managed Care; Measures; Medicaid; Mental Retardation; Modeling; Outcome; Pattern; Persons; Policies; Process; Protocols documentation; Qualifying; Relative (related person); Research; Research Personnel; Sample Size; Schools; Services; Staging; Structure; Symptoms; System; Time; United States; Variant; Work; autism spectrum disorder; care systems; community based treatment; cost; disability; evidence base; experience; health care delivery; health care service utilization; improved; meetings; programs; service utilization

DESCRIPTION (provided by applicant): This R01 application seeks support to conduct a large national study that will comprehensively identify the impact of state level autism-related policies on the publicly funded healthcare utilization of children with autism spectrum disorders (ASD). The three primary aims of the study are to 1) conduct an intensive examination of state policies and practices that may affect Medicaid-reimbursed healthcare delivery to children with ASD; 2) provide accurate national and state-level estimates of publicly-funded healthcare utilization among children with ASD; and 3) examine the relative contribution of demographic, clinical and system-of-care characteristics on the types, intensity and patterns of related service use. To accomplish these aims, we will review and code all relevant state-level policy documents to define the publicly funded healthcare service delivery system for ASD in each state. We will supplement this census through interviews with state administrators responsible for ASD-related health services. This most recent year of available Medicaid claims will be used to measure service utilization and associated expenditures at the national and state levels. We will then examine the independent associations of state policies, and school district, family and child characteristics with service utilization. These findings will provide critical information to states as they develop appropriate standards of care and related policies for the growing number of children diagnosed with ASD, and will potentially lead to policy models that improve care. This study will set the stage for future studies in which service utilization data from other systems and primary data about families' experiences and outcomes are linked to data on healthcare. The study also will provide a baseline against which to measure the effects of future system-level interventions. Finally, the results will provide evidence for a conceptual framework for understanding how states address the needs of children with chronic disabilities in which the best course of treatment and expected outcomes are uncertain.

描述（由申请人提供）：此 R01 申请寻求支持进行一项大型全国性研究，该研究将全面确定州级自闭症相关政策对自闭症谱系障碍 (ASD) 儿童的公共资助医疗保健利用的影响。该研究的三个主要目标是 1) 对可能影响向自闭症谱系障碍儿童提供医疗补助报销医疗服务的国家政策和实践进行深入审查； 2) 提供关于自闭症谱系障碍儿童公共资助医疗保健利用率的准确的国家和州级估计； 3) 检查人口、临床和护理系统特征对相关服务使用的类型、强度和模式的相对贡献。为了实现这些目标，我们将审查并编码所有相关的州级政策文件，以定义每个州针对 ASD 的公共资助的医疗服务提供系统。我们将通过采访负责 ASD 相关卫生服务的州行政人员来补充本次人口普查。最近一年的可用医疗补助索赔将用于衡量国家和州一级的服务利用率和相关支出。然后我们将考察国家政策、学区、家庭和儿童特征与服务利用的独立关联。这些发现将为各州为越来越多的被诊断患有自闭症谱系障碍的儿童制定适当的护理标准和相关政策提供重要信息，并有可能形成改善护理的政策模型。这项研究将为未来的研究奠定基础，将来自其他系统的服务利用数据以及有关家庭经历和结果的主要数据与医疗保健数据联系起来。该研究还将提供衡量未来系统级干预措施效果的基线。最后，研究结果将为概念框架提供证据，以了解各州如何满足慢性残疾儿童的需求，其中最佳治疗方案和预期结果不确定。