Centre d'Information et de documentation du CRA Rhône-Alpes
CRA
Informations pratiques
-
Adresse
Centre d'information et de documentation
du CRA Rhône-Alpes
Centre Hospitalier le Vinatier
bât 211
95, Bd Pinel
69678 Bron CedexHoraires
Lundi au Vendredi
9h00-12h00 13h30-16h00Contact
Tél: +33(0)4 37 91 54 65
Mail
Fax: +33(0)4 37 91 54 37
-
Résultat de la recherche
4 recherche sur le mot-clé 'Access to care'
Affiner la recherche Générer le flux rss de la recherche
Partager le résultat de cette recherche Faire une suggestion
They deserve the “same level of care that any other person deserves”: Caregiver perspectives on healthcare for adults on the autism spectrum / Micah O. MAZUREK in Research in Autism Spectrum Disorders, 89 (November 2021)
[article]
Titre : They deserve the “same level of care that any other person deserves”: Caregiver perspectives on healthcare for adults on the autism spectrum Type de document : Texte imprimé et/ou numérique Auteurs : Micah O. MAZUREK, Auteur ; Eleonora SADIKOVA, Auteur ; Nancy C. CHEAK-ZAMORA, Auteur ; Amber HARDIN, Auteur ; Isabel HUERTA, Auteur ; Kristin SOHL, Auteur ; Beth A. MALOW, Auteur Article en page(s) : 101862 Langues : Anglais (eng) Mots-clés : Autism Adult Healthcare Primary care Mental health Access to care Index. décimale : PER Périodiques Résumé : Background Adults on the autism spectrum are at high risk for co-occurring conditions and poor health outcomes, yet they often experience significant unmet healthcare needs. A better understanding of potential gaps and barriers is essential for improving the healthcare system. This mixed-methods study was conducted to better understand the healthcare needs and experiences of adults on the autism spectrum from the perspective of parents and caregivers. Method Twenty-four caregivers of adults on the autism spectrum (21 mothers, 2 fathers, 1 non-parent caregiver) completed surveys and participated in one of seven focus group interviews to share their perspectives regarding healthcare needs, experiences, and suggestions for improvement. Results Survey responses indicated general satisfaction with primary care; however, in-depth qualitative data analyses revealed four primary themes and 10 subthemes. The first theme focused on barriers to healthcare access and included insurance coverage, geographic distance, waitlists, and provider shortages. Caregivers also expressed dissatisfaction with healthcare quality (Theme 2), particularly a lack of provider knowledge resulting in inadequate treatment. Participants also emphasized the need for comprehensive and coordinated healthcare services (Theme 3), and described pressure on parents to advocate and coordinate care. Finally, caregivers stressed the importance of person-centered care (Theme 4), particularly the need for accommodations and rapport for adults on the spectrum. Conclusions These results indicate that the nature and quality of current healthcare services may not be adequate to meet the needs of adults on the autism spectrum. The suggestions provided by caregivers should be used to inform strategies for healthcare improvement. En ligne : https://doi.org/10.1016/j.rasd.2021.101862 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=458
in Research in Autism Spectrum Disorders > 89 (November 2021) . - 101862[article] They deserve the “same level of care that any other person deserves”: Caregiver perspectives on healthcare for adults on the autism spectrum [Texte imprimé et/ou numérique] / Micah O. MAZUREK, Auteur ; Eleonora SADIKOVA, Auteur ; Nancy C. CHEAK-ZAMORA, Auteur ; Amber HARDIN, Auteur ; Isabel HUERTA, Auteur ; Kristin SOHL, Auteur ; Beth A. MALOW, Auteur . - 101862.
Langues : Anglais (eng)
in Research in Autism Spectrum Disorders > 89 (November 2021) . - 101862
Mots-clés : Autism Adult Healthcare Primary care Mental health Access to care Index. décimale : PER Périodiques Résumé : Background Adults on the autism spectrum are at high risk for co-occurring conditions and poor health outcomes, yet they often experience significant unmet healthcare needs. A better understanding of potential gaps and barriers is essential for improving the healthcare system. This mixed-methods study was conducted to better understand the healthcare needs and experiences of adults on the autism spectrum from the perspective of parents and caregivers. Method Twenty-four caregivers of adults on the autism spectrum (21 mothers, 2 fathers, 1 non-parent caregiver) completed surveys and participated in one of seven focus group interviews to share their perspectives regarding healthcare needs, experiences, and suggestions for improvement. Results Survey responses indicated general satisfaction with primary care; however, in-depth qualitative data analyses revealed four primary themes and 10 subthemes. The first theme focused on barriers to healthcare access and included insurance coverage, geographic distance, waitlists, and provider shortages. Caregivers also expressed dissatisfaction with healthcare quality (Theme 2), particularly a lack of provider knowledge resulting in inadequate treatment. Participants also emphasized the need for comprehensive and coordinated healthcare services (Theme 3), and described pressure on parents to advocate and coordinate care. Finally, caregivers stressed the importance of person-centered care (Theme 4), particularly the need for accommodations and rapport for adults on the spectrum. Conclusions These results indicate that the nature and quality of current healthcare services may not be adequate to meet the needs of adults on the autism spectrum. The suggestions provided by caregivers should be used to inform strategies for healthcare improvement. En ligne : https://doi.org/10.1016/j.rasd.2021.101862 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=458 Including Children with Developmental Disabilities in the Equation During this COVID-19 Pandemic / Ramkumar AISHWORIYA in Journal of Autism and Developmental Disorders, 51-6 (June 2021)
[article]
Titre : Including Children with Developmental Disabilities in the Equation During this COVID-19 Pandemic Type de document : Texte imprimé et/ou numérique Auteurs : Ramkumar AISHWORIYA, Auteur ; Y. Q. KANG, Auteur Article en page(s) : p.2155-2158 Langues : Anglais (eng) Mots-clés : Autism Spectrum Disorder/epidemiology/psychology/therapy COVID-19/epidemiology/prevention & control/psychology Child Developmental Disabilities/epidemiology/psychology/therapy Health Personnel/psychology Health Services Accessibility/trends Humans Mental Health/trends Pandemics SARS-CoV-2 Access to care Covid-19 Children Developmental delay Inequities Index. décimale : PER Périodiques Résumé : Amidst the ongoing novel Coronavirus disease pandemic, children with developmental disabilities warrant specific attention to minimise having disproportionate consequences. These children are especially vulnerable to the effects of the pandemic due to (1) Greater healthcare needs, (2) Dependency on community-based services and (3) Mental health concerns. Healthcare professionals, public health systems and the society needs to come together to advocate for these children by optimising access to healthcare and community intervention services, promoting mental well-being and caregiver welfare. The consequences of missed present-day opportunities might only be evident in the years to come in these children. Hence, despite the prolonged pandemic, with consequent limitations in availability of resources, children with developmental disabilities should continue to be supported. En ligne : http://dx.doi.org/10.1007/s10803-020-04670-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=452
in Journal of Autism and Developmental Disorders > 51-6 (June 2021) . - p.2155-2158[article] Including Children with Developmental Disabilities in the Equation During this COVID-19 Pandemic [Texte imprimé et/ou numérique] / Ramkumar AISHWORIYA, Auteur ; Y. Q. KANG, Auteur . - p.2155-2158.
Langues : Anglais (eng)
in Journal of Autism and Developmental Disorders > 51-6 (June 2021) . - p.2155-2158
Mots-clés : Autism Spectrum Disorder/epidemiology/psychology/therapy COVID-19/epidemiology/prevention & control/psychology Child Developmental Disabilities/epidemiology/psychology/therapy Health Personnel/psychology Health Services Accessibility/trends Humans Mental Health/trends Pandemics SARS-CoV-2 Access to care Covid-19 Children Developmental delay Inequities Index. décimale : PER Périodiques Résumé : Amidst the ongoing novel Coronavirus disease pandemic, children with developmental disabilities warrant specific attention to minimise having disproportionate consequences. These children are especially vulnerable to the effects of the pandemic due to (1) Greater healthcare needs, (2) Dependency on community-based services and (3) Mental health concerns. Healthcare professionals, public health systems and the society needs to come together to advocate for these children by optimising access to healthcare and community intervention services, promoting mental well-being and caregiver welfare. The consequences of missed present-day opportunities might only be evident in the years to come in these children. Hence, despite the prolonged pandemic, with consequent limitations in availability of resources, children with developmental disabilities should continue to be supported. En ligne : http://dx.doi.org/10.1007/s10803-020-04670-6 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=452 Treatment patterns in children with autism in the United States / B. U. MONZ in Autism Research, 12-3 (March 2019)
[article]
Titre : Treatment patterns in children with autism in the United States Type de document : Texte imprimé et/ou numérique Auteurs : B. U. MONZ, Auteur ; R. HOUGHTON, Auteur ; K. LAW, Auteur ; G. LOSS, Auteur Article en page(s) : p.517-526 Langues : Anglais (eng) Mots-clés : Medicaid access to care autism spectrum disorder children private insurance rural service use urban Index. décimale : PER Périodiques Résumé : Children with autism receive different types of non-drug treatments. We aimed to describe caregiver-reported pattern of care and its variability by geography and healthcare coverage in a US-wide sample of children aged 3-17 years. We recruited caregivers from the Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Two online questionnaires (non-drug treatment, Autism Impact Measure) were completed in September/October 2017. Primary outcome measures were caregiver-reported types and intensities of treatments (behavioral, developmental/relationship, speech and language (SLT), occupational, psychological, "other"; parent/caregiver training) in the previous 12 months. Main explanatory variables were geography and type of healthcare coverage. We investigated associations between the type/intensity of treatments and geography (metropolitan/nonmetropolitan) or coverage (Medicaid vs privately insured by employer) using regression analysis. Caregivers (n = 5,122) were mainly mothers (92.1%) with mean (SD) age of 39.0 (7.3) years. Mean child age was 9.1 (3.9) years; mostly males (80.0%). Almost all children received at least one intervention (96.0%). Eighty percent received SLT or occupational therapy, while 52.0% received both. Behavioral therapy and SLT were significantly more frequent and more intense in metropolitan than in nonmetropolitan areas. No consistently significant associations were seen between healthcare coverage and frequency or intensity of interventions. At least one barrier such as "waiting list" and "no coverage" was reported by 44.8%. In conclusion, in children sampled from SPARK, we observed differences between metropolitan and nonmetropolitan areas, while we did not find significant differences between those privately insured versus Medicaid. Autism Res 2019, 12: 517-526 (c) 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: The American Academy of Child and Adolescent Psychiatry recommends the use of multiple treatment modalities in autism spectrum disorder (ASD). We wanted to understand what types of treatment children (aged 3-17 years) with ASD receive in the United States, how and where the treatments take place and for how long. We invited caregivers from Simons Foundation Powering Autism Research for Knowledge ("SPARK ," https://sparkforautism.org/) to complete the study questions online. Participants reported on utilization of conventional, non-drug treatments for ASD, including behavioral interventions, developmental/relationship interventions, speech and language therapy (SLT), occupational therapy, psychological therapy, and parent/caregiver training. People that completed the study (n = 5,122) were primarily mothers of the child with ASD (92%); most of the children were boys (80%). The ASD care for the child was mostly coordinating by the mother. Almost all children received at least some type of non-drug therapies (96%), most often SLT and/or occupational therapy, mainly provided in school. Behavioral therapy was most often received in public school in rural areas, while at home in urban areas. We saw less use of behavioral therapy and SLT in rural areas, but overall comparable use between children covered by Medicaid and those covered by private insurance. Almost half the caregivers reported at least one barrier to treatment, such as "waiting list" and "no coverage." More than half said that their child benefited "much" or "very much" from the therapies received. While overall non-drug treatment rates for children with ASD were high in the United States in our study, differences existed depending on where the family lives; not only regarding the type of therapy, but also where it takes place. En ligne : http://dx.doi.org/10.1002/aur.2070 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=387
in Autism Research > 12-3 (March 2019) . - p.517-526[article] Treatment patterns in children with autism in the United States [Texte imprimé et/ou numérique] / B. U. MONZ, Auteur ; R. HOUGHTON, Auteur ; K. LAW, Auteur ; G. LOSS, Auteur . - p.517-526.
Langues : Anglais (eng)
in Autism Research > 12-3 (March 2019) . - p.517-526
Mots-clés : Medicaid access to care autism spectrum disorder children private insurance rural service use urban Index. décimale : PER Périodiques Résumé : Children with autism receive different types of non-drug treatments. We aimed to describe caregiver-reported pattern of care and its variability by geography and healthcare coverage in a US-wide sample of children aged 3-17 years. We recruited caregivers from the Simons Foundation Powering Autism Research for Knowledge (SPARK) cohort. Two online questionnaires (non-drug treatment, Autism Impact Measure) were completed in September/October 2017. Primary outcome measures were caregiver-reported types and intensities of treatments (behavioral, developmental/relationship, speech and language (SLT), occupational, psychological, "other"; parent/caregiver training) in the previous 12 months. Main explanatory variables were geography and type of healthcare coverage. We investigated associations between the type/intensity of treatments and geography (metropolitan/nonmetropolitan) or coverage (Medicaid vs privately insured by employer) using regression analysis. Caregivers (n = 5,122) were mainly mothers (92.1%) with mean (SD) age of 39.0 (7.3) years. Mean child age was 9.1 (3.9) years; mostly males (80.0%). Almost all children received at least one intervention (96.0%). Eighty percent received SLT or occupational therapy, while 52.0% received both. Behavioral therapy and SLT were significantly more frequent and more intense in metropolitan than in nonmetropolitan areas. No consistently significant associations were seen between healthcare coverage and frequency or intensity of interventions. At least one barrier such as "waiting list" and "no coverage" was reported by 44.8%. In conclusion, in children sampled from SPARK, we observed differences between metropolitan and nonmetropolitan areas, while we did not find significant differences between those privately insured versus Medicaid. Autism Res 2019, 12: 517-526 (c) 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: The American Academy of Child and Adolescent Psychiatry recommends the use of multiple treatment modalities in autism spectrum disorder (ASD). We wanted to understand what types of treatment children (aged 3-17 years) with ASD receive in the United States, how and where the treatments take place and for how long. We invited caregivers from Simons Foundation Powering Autism Research for Knowledge ("SPARK ," https://sparkforautism.org/) to complete the study questions online. Participants reported on utilization of conventional, non-drug treatments for ASD, including behavioral interventions, developmental/relationship interventions, speech and language therapy (SLT), occupational therapy, psychological therapy, and parent/caregiver training. People that completed the study (n = 5,122) were primarily mothers of the child with ASD (92%); most of the children were boys (80%). The ASD care for the child was mostly coordinating by the mother. Almost all children received at least some type of non-drug therapies (96%), most often SLT and/or occupational therapy, mainly provided in school. Behavioral therapy was most often received in public school in rural areas, while at home in urban areas. We saw less use of behavioral therapy and SLT in rural areas, but overall comparable use between children covered by Medicaid and those covered by private insurance. Almost half the caregivers reported at least one barrier to treatment, such as "waiting list" and "no coverage." More than half said that their child benefited "much" or "very much" from the therapies received. While overall non-drug treatment rates for children with ASD were high in the United States in our study, differences existed depending on where the family lives; not only regarding the type of therapy, but also where it takes place. En ligne : http://dx.doi.org/10.1002/aur.2070 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=387 Changes in spending and service use after a state autism insurance mandate / B. SALONER in Autism, 23-1 (January 2019)
[article]
Titre : Changes in spending and service use after a state autism insurance mandate Type de document : Texte imprimé et/ou numérique Auteurs : B. SALONER, Auteur ; C. L. BARRY, Auteur Article en page(s) : p.167-174 Langues : Anglais (eng) Mots-clés : access to care health insurance insurance mandate out-of-pocket spending utilization spectrum disorder children impact costs Psychology Index. décimale : PER Périodiques Résumé : Almost all states have insurance coverage mandates for childhood autism spectrum disorder treatment, yet little is known about how mandates affect spending and service use. We evaluated a 2011 Kansas law mandating comprehensive coverage of autism spectrum disorder treatments in the State Employee Health Plan. Data were extracted from the Kansas All-Payer Claims Database from 2009 to 2013 for enrollees of State Employee Health Plan and private health plans. The sample included children aged 0-18 years with >2 claims with an autism spectrum disorder diagnosis insured through State Employee Health Plan or a comparison group enrolled through private health plans. We estimated differences-in-differences regression models to compare trends among State Employee Health Plan to privately insured children. Average annual total spending on autism spectrum disorder services increased by US$912 (95% confidence interval: US$331-US$1492) and average annual out-of-pocket spending on autism spectrum disorder services increased by US$138 (95% confidence interval: US$53-US$223) among diagnosed children in the State Employee Health Plan relative to the comparison group following the mandate, representing 92% and 75% increases over baseline total and out-of-pocket autism spectrum disorder spending, respectively. Average annual quantity of outpatient autism spectrum disorder services increased by 15.0 services (95% confidence interval: 8.4-21.6) among children in the State Employee Health Plan, more than doubling the baseline average. Implementation of a comprehensive autism spectrum disorder mandate in the Kansas State Employee Health Plan was associated with substantial increases in service use and spending for autism spectrum disorder treatment among autism spectrum disorder-diagnosed children. En ligne : http://dx.doi.org/10.1177/1362361317728205 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=379
in Autism > 23-1 (January 2019) . - p.167-174[article] Changes in spending and service use after a state autism insurance mandate [Texte imprimé et/ou numérique] / B. SALONER, Auteur ; C. L. BARRY, Auteur . - p.167-174.
Langues : Anglais (eng)
in Autism > 23-1 (January 2019) . - p.167-174
Mots-clés : access to care health insurance insurance mandate out-of-pocket spending utilization spectrum disorder children impact costs Psychology Index. décimale : PER Périodiques Résumé : Almost all states have insurance coverage mandates for childhood autism spectrum disorder treatment, yet little is known about how mandates affect spending and service use. We evaluated a 2011 Kansas law mandating comprehensive coverage of autism spectrum disorder treatments in the State Employee Health Plan. Data were extracted from the Kansas All-Payer Claims Database from 2009 to 2013 for enrollees of State Employee Health Plan and private health plans. The sample included children aged 0-18 years with >2 claims with an autism spectrum disorder diagnosis insured through State Employee Health Plan or a comparison group enrolled through private health plans. We estimated differences-in-differences regression models to compare trends among State Employee Health Plan to privately insured children. Average annual total spending on autism spectrum disorder services increased by US$912 (95% confidence interval: US$331-US$1492) and average annual out-of-pocket spending on autism spectrum disorder services increased by US$138 (95% confidence interval: US$53-US$223) among diagnosed children in the State Employee Health Plan relative to the comparison group following the mandate, representing 92% and 75% increases over baseline total and out-of-pocket autism spectrum disorder spending, respectively. Average annual quantity of outpatient autism spectrum disorder services increased by 15.0 services (95% confidence interval: 8.4-21.6) among children in the State Employee Health Plan, more than doubling the baseline average. Implementation of a comprehensive autism spectrum disorder mandate in the Kansas State Employee Health Plan was associated with substantial increases in service use and spending for autism spectrum disorder treatment among autism spectrum disorder-diagnosed children. En ligne : http://dx.doi.org/10.1177/1362361317728205 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=379