Health status of Medicare-enrolled autistic older adults with and without co-occurring intellectual disability: An analysis of inpatient and institutional outpatient medical claims / Daniel GILMORE in Autism, 25-1 (January 2021)  

Public ISBD [article]  inAutism > 25-1 (January 2021) . - p.266-274 Titre : Health status of Medicare-enrolled autistic older adults with and without co-occurring intellectual disability: An analysis of inpatient and institutional outpatient medical claims Type de document : Texte imprimé et/ou numérique Auteurs : Daniel GILMORE, Auteur ; Lauren HARRIS, Auteur ; Anne LONGO, Auteur ; Brittany N. HAND, Auteur Article en page(s) : p.266-274 Langues : Anglais (eng) Mots-clés : adults  autism spectrum disorders  health services  intellectual disability  medical comorbidity  psychiatric comorbidity Index. décimale : PER Périodiques Résumé : Little is known about the extent to which the healthcare needs of autistic older adults with intellectual disability differ from autistic older adults without intellectual disability. Our study is the first, to our knowledge, to use US national data to compare physical and mental health conditions among autistic older adults with and without intellectual disability. The data analyzed in this study consisted of records from inpatient hospitalizations as well as "institutional outpatient" healthcare visits, which include visits to hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, Federally Qualified Health Centers, and community mental health centers. Autistic older adults with intellectual disability were significantly more likely to have thyroid disorders, epilepsy, respiratory infections, gastrointestinal conditions, osteoporosis, cognitive disorders, and schizophrenia/psychotic disorders. In contrast, autistic older adults without intellectual disability were significantly more likely to have obesity, diabetes, high blood pressure, cerebrovascular disease, chronic obstructive pulmonary disease, arthritis, back conditions, attention deficit disorders, substance use disorders, and suicidal ideation or intentional self-injury. These findings highlight the importance of developing distinct, tailored health management strategies for the autistic older adults with and without intellectual disability. En ligne : http://dx.doi.org/10.1177/1362361320955109 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437 [article] Health status of Medicare-enrolled autistic older adults with and without co-occurring intellectual disability: An analysis of inpatient and institutional outpatient medical claims [Texte imprimé et/ou numérique] / Daniel GILMORE, Auteur ; Lauren HARRIS, Auteur ; Anne LONGO, Auteur ; Brittany N. HAND, Auteur . - p.266-274. Langues : Anglais (eng) in Autism > 25-1 (January 2021) . - p.266-274 Mots-clés : adults  autism spectrum disorders  health services  intellectual disability  medical comorbidity  psychiatric comorbidity Index. décimale : PER Périodiques Résumé : Little is known about the extent to which the healthcare needs of autistic older adults with intellectual disability differ from autistic older adults without intellectual disability. Our study is the first, to our knowledge, to use US national data to compare physical and mental health conditions among autistic older adults with and without intellectual disability. The data analyzed in this study consisted of records from inpatient hospitalizations as well as "institutional outpatient" healthcare visits, which include visits to hospital outpatient departments, rural health clinics, renal dialysis facilities, outpatient rehabilitation facilities, Federally Qualified Health Centers, and community mental health centers. Autistic older adults with intellectual disability were significantly more likely to have thyroid disorders, epilepsy, respiratory infections, gastrointestinal conditions, osteoporosis, cognitive disorders, and schizophrenia/psychotic disorders. In contrast, autistic older adults without intellectual disability were significantly more likely to have obesity, diabetes, high blood pressure, cerebrovascular disease, chronic obstructive pulmonary disease, arthritis, back conditions, attention deficit disorders, substance use disorders, and suicidal ideation or intentional self-injury. These findings highlight the importance of developing distinct, tailored health management strategies for the autistic older adults with and without intellectual disability. En ligne : http://dx.doi.org/10.1177/1362361320955109 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437

Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults / Brittany N. HAND in Autism, 24-3 (April 2020)  

Public ISBD [article]  inAutism > 24-3 (April 2020) . - p.755-764 Titre : Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults Type de document : Texte imprimé et/ou numérique Auteurs : Brittany N. HAND, Auteur ; Amber M. ANGELL, Auteur ; Lauren HARRIS, Auteur ; Laura A. CARPENTER, Auteur Article en page(s) : p.755-764 Langues : Anglais (eng) Mots-clés : adults  autism spectrum disorders  health services  medical comorbidity  psychiatric comorbidity Index. décimale : PER Périodiques Résumé : While there is emerging evidence on the prevalence of physical and mental health conditions among autistic adults, less is known about this population's needs during older adulthood (aged 65+). We conducted a cross-sectional retrospective cohort study of 2016-2017 Medicare data to compare the prevalence of physical and mental health conditions in a national sample of autistic older adults (N = 4685) to a matched population comparison (N = 46,850) cohort. Autistic older adults had significantly greater odds of nearly all physical health conditions including epilepsy (odds ratio = 18.9; 95% confidence interval = 17.2-20.7), Parkinson's disease (odds ratio = 6.1; 95% confidence interval = 5.3-7.0), and gastrointestinal conditions (odds ratio = 5.2; 95% confidence interval = 4.9-5.5). Most mental health conditions were more common among autistic older adults, including schizophrenia and psychotic disorders (odds ratio = 25.3; 95% confidence interval = 22.4-28.7), attention deficit disorders (odds ratio = 24.4; 95% confidence interval = 16.2-31.0), personality disorders (odds ratio = 24.1; 95% confidence interval = 17.8-32.5), and suicidality or self-inflicted injury (odds ratio = 11.1; 95% confidence interval = 8.9-13.8). Health conditions commonly associated with advanced age in the general population (e.g. osteoporosis, cognitive disorders, heart disease, cancer, cerebrovascular disease, osteoarthritis) were also significantly more common among autistic older adults. By highlighting the significant physical and mental health needs for which autistic older adults require care, our findings can inform healthcare systems, healthcare providers, and public health initiatives seeking to promote well-being in this growing population. En ligne : http://dx.doi.org/10.1177/1362361319890793 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422 [article] Prevalence of physical and mental health conditions in Medicare-enrolled, autistic older adults [Texte imprimé et/ou numérique] / Brittany N. HAND, Auteur ; Amber M. ANGELL, Auteur ; Lauren HARRIS, Auteur ; Laura A. CARPENTER, Auteur . - p.755-764. Langues : Anglais (eng) in Autism > 24-3 (April 2020) . - p.755-764 Mots-clés : adults  autism spectrum disorders  health services  medical comorbidity  psychiatric comorbidity Index. décimale : PER Périodiques Résumé : While there is emerging evidence on the prevalence of physical and mental health conditions among autistic adults, less is known about this population's needs during older adulthood (aged 65+). We conducted a cross-sectional retrospective cohort study of 2016-2017 Medicare data to compare the prevalence of physical and mental health conditions in a national sample of autistic older adults (N = 4685) to a matched population comparison (N = 46,850) cohort. Autistic older adults had significantly greater odds of nearly all physical health conditions including epilepsy (odds ratio = 18.9; 95% confidence interval = 17.2-20.7), Parkinson's disease (odds ratio = 6.1; 95% confidence interval = 5.3-7.0), and gastrointestinal conditions (odds ratio = 5.2; 95% confidence interval = 4.9-5.5). Most mental health conditions were more common among autistic older adults, including schizophrenia and psychotic disorders (odds ratio = 25.3; 95% confidence interval = 22.4-28.7), attention deficit disorders (odds ratio = 24.4; 95% confidence interval = 16.2-31.0), personality disorders (odds ratio = 24.1; 95% confidence interval = 17.8-32.5), and suicidality or self-inflicted injury (odds ratio = 11.1; 95% confidence interval = 8.9-13.8). Health conditions commonly associated with advanced age in the general population (e.g. osteoporosis, cognitive disorders, heart disease, cancer, cerebrovascular disease, osteoarthritis) were also significantly more common among autistic older adults. By highlighting the significant physical and mental health needs for which autistic older adults require care, our findings can inform healthcare systems, healthcare providers, and public health initiatives seeking to promote well-being in this growing population. En ligne : http://dx.doi.org/10.1177/1362361319890793 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=422

Specialized primary care medical home: A positive impact on continuity of care among autistic adults / Brittany N. HAND in Autism, 25-1 (January 2021)  

Public ISBD [article]  inAutism > 25-1 (January 2021) . - p.258-265 Titre : Specialized primary care medical home: A positive impact on continuity of care among autistic adults Type de document : Texte imprimé et/ou numérique Auteurs : Brittany N. HAND, Auteur ; Daniel L. COURY, Auteur ; Susan W. WHITE, Auteur ; Amy R. DARRAGH, Auteur ; Susan MOFFATT-BRUCE, Auteur ; Lauren HARRIS, Auteur ; Anne LONGO, Auteur ; Jennifer H. GARVIN, Auteur Article en page(s) : p.258-265 Langues : Anglais (eng) Mots-clés : adults  autism spectrum disorders  continuity of care  health services  primary care Index. décimale : PER Périodiques Résumé : There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the "medical home". The medical home is not a residential home, but a system where a patient's healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults. En ligne : http://dx.doi.org/10.1177/1362361320953967 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437 [article] Specialized primary care medical home: A positive impact on continuity of care among autistic adults [Texte imprimé et/ou numérique] / Brittany N. HAND, Auteur ; Daniel L. COURY, Auteur ; Susan W. WHITE, Auteur ; Amy R. DARRAGH, Auteur ; Susan MOFFATT-BRUCE, Auteur ; Lauren HARRIS, Auteur ; Anne LONGO, Auteur ; Jennifer H. GARVIN, Auteur . - p.258-265. Langues : Anglais (eng) in Autism > 25-1 (January 2021) . - p.258-265 Mots-clés : adults  autism spectrum disorders  continuity of care  health services  primary care Index. décimale : PER Périodiques Résumé : There is a nationally recognized need for innovative healthcare delivery models to improve care continuity for autistic adults as they age out of pediatric and into adult healthcare systems. One possible model of care delivery is called the "medical home". The medical home is not a residential home, but a system where a patient's healthcare is coordinated through a primary care physician to ensure necessary care is received when and where the patient needs it. We compared the continuity of care among autistic adult patients at a specialized primary care medical home designed to remove barriers to care for autistic adults, called the CAST, to matched national samples of autistic adults with private insurance or Medicare. Continuity of primary care among CAST patients was significantly better than that of matched national samples of autistic adult Medicare beneficiaries and similar to that of privately insured autistic adults. Our findings suggest that medical homes, like CAST, are a promising solution to improve healthcare delivery for the growing population of autistic adults. En ligne : http://dx.doi.org/10.1177/1362361320953967 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=437

Suicidal Ideation and Self-inflicted Injury in Medicare Enrolled Autistic Adults With and Without Co-occurring Intellectual Disability / Brittany N. HAND in Journal of Autism and Developmental Disorders, 50-10 (October 2020)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 50-10 (October 2020) . - p.3489-3495 Titre : Suicidal Ideation and Self-inflicted Injury in Medicare Enrolled Autistic Adults With and Without Co-occurring Intellectual Disability Type de document : Texte imprimé et/ou numérique Auteurs : Brittany N. HAND, Auteur ; Teal W. BENEVIDES, Auteur ; Henry J. CARRETTA, Auteur Article en page(s) : p.3489-3495 Langues : Anglais (eng) Mots-clés : Adults  Aging/ASD in adults  Intellectual disability  Suicidal ideation  Suicidality  Suicide  Suicide attempts Index. décimale : PER Périodiques Résumé : Suicidality is significantly more common in autistic adults than the general population, yet the factors that increase risk for suicidality among autistic adults remain largely unknown. We identified characteristics associated with suicidal ideation and suicide attempts/self-inflicted injury in a U.S. national sample of Medicare-enrolled autistic adults. We conducted a case-control study of autistic adults aged 18-59 years (n?=?21,792). Younger age, white race, depression disorders, and psychiatric healthcare utilization were associated with increased odds of suicidal ideation and suicide attempts. Co-occurring intellectual disability was associated with significantly greater odds of a suicide attempt, but lower odds of suicidal ideation. Findings underscore the need for improved methods to identify ideation prior to attempt among adults with autism and intellectual disability. En ligne : http://dx.doi.org/10.1007/s10803-019-04345-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=432 [article] Suicidal Ideation and Self-inflicted Injury in Medicare Enrolled Autistic Adults With and Without Co-occurring Intellectual Disability [Texte imprimé et/ou numérique] / Brittany N. HAND, Auteur ; Teal W. BENEVIDES, Auteur ; Henry J. CARRETTA, Auteur . - p.3489-3495. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 50-10 (October 2020) . - p.3489-3495 Mots-clés : Adults  Aging/ASD in adults  Intellectual disability  Suicidal ideation  Suicidality  Suicide  Suicide attempts Index. décimale : PER Périodiques Résumé : Suicidality is significantly more common in autistic adults than the general population, yet the factors that increase risk for suicidality among autistic adults remain largely unknown. We identified characteristics associated with suicidal ideation and suicide attempts/self-inflicted injury in a U.S. national sample of Medicare-enrolled autistic adults. We conducted a case-control study of autistic adults aged 18-59 years (n?=?21,792). Younger age, white race, depression disorders, and psychiatric healthcare utilization were associated with increased odds of suicidal ideation and suicide attempts. Co-occurring intellectual disability was associated with significantly greater odds of a suicide attempt, but lower odds of suicidal ideation. Findings underscore the need for improved methods to identify ideation prior to attempt among adults with autism and intellectual disability. En ligne : http://dx.doi.org/10.1007/s10803-019-04345-x Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=432

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