Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum / Whitney SCHOTT in Autism Research, 15-1 (January 2022)  

Public ISBD [article]  inAutism Research > 15-1 (January 2022) . - p.70-85 Titre : Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum Type de document : texte imprimé Auteurs : Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay L. SHEA, Auteur Article en page(s) : p.70-85 Langues : Anglais (eng) Mots-clés : Adult  Autism Spectrum Disorder/epidemiology  Autistic Disorder  Ethnicity  Humans  Medicaid  Minority Groups  United States/epidemiology  adults  autism  co-occurring conditions  racial disparities Index. décimale : PER Périodiques Résumé : Evidence suggests that autistic adults have higher odds of developing several co-occurring conditions, but less is known about disparities by race and ethnicity in this population. Using 2008-2012 Medicaid Analytic eXtract (MAX) data, we (i) identify the prevalence of co-occurring conditions among the population of autistic adult Medicaid beneficiaries compared to a matched sample of those without an autism spectrum disorder (ASD) diagnosis, (ii) conduct logistic regression to estimate odds ratios for these health conditions predicted by an autism diagnosis, and (iii) estimate odds of having these health conditions as predicted by racial/ethnic group among the autistic population only. Overall, autistic adults did not have higher prevalence of some major health conditions (cardiovascular conditions, stroke, cancer, cardiovascular disease), but they did have higher odds of others (nutrition conditions, epilepsy, disorders of the central nervous system). Analysis by racial/ethnic group, however, shows that Black, Hispanic, and Asian autistic beneficiaries had higher odds of diabetes, hospitalized cardiovascular diseases, and hypertension, among other conditions. Policymakers should be aware that racial disparities found in the general population persist in the autistic population and should work to implement systems and programs to improve screening and preventive care for minority autistic populations. LAY SUMMARY: Autistic adults may have several co-occurring physical and mental health conditions, which could differ by racial/ethnic group. We find that, compared to the general Medicaid population, autistic adult Medicaid beneficiaries have elevated odds of some health conditions, like epilepsy and nutrition conditions, as well as some psychiatric conditions, such as anxiety and attention disorders. We also find that many of the same health disparities by racial/ethnic group in the general population persist among the autistic adult Medicaid population. For example, Black, Hispanic, and Asian Medicaid autistic beneficiaries have higher odds of diabetes, and Black and Hispanic autistic beneficiaries have higher odds of obesity and nutrition conditions than white autistic beneficiaries. En ligne : http://dx.doi.org/10.1002/aur.2644 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=450 [article] Co-occurring conditions and racial-ethnic disparities: Medicaid enrolled adults on the autism spectrum [texte imprimé] / Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay L. SHEA, Auteur . - p.70-85. Langues : Anglais (eng) in Autism Research > 15-1 (January 2022) . - p.70-85 Mots-clés : Adult  Autism Spectrum Disorder/epidemiology  Autistic Disorder  Ethnicity  Humans  Medicaid  Minority Groups  United States/epidemiology  adults  autism  co-occurring conditions  racial disparities Index. décimale : PER Périodiques Résumé : Evidence suggests that autistic adults have higher odds of developing several co-occurring conditions, but less is known about disparities by race and ethnicity in this population. Using 2008-2012 Medicaid Analytic eXtract (MAX) data, we (i) identify the prevalence of co-occurring conditions among the population of autistic adult Medicaid beneficiaries compared to a matched sample of those without an autism spectrum disorder (ASD) diagnosis, (ii) conduct logistic regression to estimate odds ratios for these health conditions predicted by an autism diagnosis, and (iii) estimate odds of having these health conditions as predicted by racial/ethnic group among the autistic population only. Overall, autistic adults did not have higher prevalence of some major health conditions (cardiovascular conditions, stroke, cancer, cardiovascular disease), but they did have higher odds of others (nutrition conditions, epilepsy, disorders of the central nervous system). Analysis by racial/ethnic group, however, shows that Black, Hispanic, and Asian autistic beneficiaries had higher odds of diabetes, hospitalized cardiovascular diseases, and hypertension, among other conditions. Policymakers should be aware that racial disparities found in the general population persist in the autistic population and should work to implement systems and programs to improve screening and preventive care for minority autistic populations. LAY SUMMARY: Autistic adults may have several co-occurring physical and mental health conditions, which could differ by racial/ethnic group. We find that, compared to the general Medicaid population, autistic adult Medicaid beneficiaries have elevated odds of some health conditions, like epilepsy and nutrition conditions, as well as some psychiatric conditions, such as anxiety and attention disorders. We also find that many of the same health disparities by racial/ethnic group in the general population persist among the autistic adult Medicaid population. For example, Black, Hispanic, and Asian Medicaid autistic beneficiaries have higher odds of diabetes, and Black and Hispanic autistic beneficiaries have higher odds of obesity and nutrition conditions than white autistic beneficiaries. En ligne : http://dx.doi.org/10.1002/aur.2644 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=450

COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions / Whitney SCHOTT in Autism, 26-4 (May 2022)  

Public ISBD [article]  inAutism > 26-4 (May 2022) . - p.975-987 Titre : COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions Type de document : texte imprimé Auteurs : Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay L. SHEA, Auteur Article en page(s) : p.975-987 Langues : Anglais (eng) Mots-clés : Adult  Autism Spectrum Disorder/epidemiology  Autistic Disorder/epidemiology  COVID-19/epidemiology  Humans  Intellectual Disability/epidemiology  Medicaid  Mental Health  United States/epidemiology  COVID-19 risk  autism  comorbidities  intellectual disability Index. décimale : PER Périodiques Résumé : Autistic adults, adults with intellectual disability, and adults with other mental health conditions may have higher risk of contracting COVID-19 or experiencing more severe illness from COVID-19 if infected. We used data from Medicaid to look at whether autistic adults and other adults with intellectual disability and other mental health conditions were more likely to have risk factors for COVID-19, such as living in a residential facility, receiving services regularly in the home from outside caregivers, having had a long hospitalization, having had avoidable hospitalizations, and having high-risk health conditions. We found that autistic adults had higher odds of living in a residential facility, receiving in-home services from outside caregivers, having had an avoidable hospitalization, and having a high-risk health condition, compared to neurotypical adults without mental health conditions. Adults with intellectual disability had similar odds of having these conditions. Adults with other mental health conditions were also more likely to live in a residential facility, receive services from outside caregivers, and have had avoidable hospitalizations compared to the neurotypical population without mental health conditions. They had three times higher odds of having a high-risk health condition. High risk of COVID-19 among autistic adults and adults with intellectual disability and mental health conditions should be recognized by clinicians, and these groups should be prioritized for vaccine outreach. En ligne : https://dx.doi.org/10.1177/13623613211039662 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=473 [article] COVID-19 risk: Adult Medicaid beneficiaries with autism, intellectual disability, and mental health conditions [texte imprimé] / Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay L. SHEA, Auteur . - p.975-987. Langues : Anglais (eng) in Autism > 26-4 (May 2022) . - p.975-987 Mots-clés : Adult  Autism Spectrum Disorder/epidemiology  Autistic Disorder/epidemiology  COVID-19/epidemiology  Humans  Intellectual Disability/epidemiology  Medicaid  Mental Health  United States/epidemiology  COVID-19 risk  autism  comorbidities  intellectual disability Index. décimale : PER Périodiques Résumé : Autistic adults, adults with intellectual disability, and adults with other mental health conditions may have higher risk of contracting COVID-19 or experiencing more severe illness from COVID-19 if infected. We used data from Medicaid to look at whether autistic adults and other adults with intellectual disability and other mental health conditions were more likely to have risk factors for COVID-19, such as living in a residential facility, receiving services regularly in the home from outside caregivers, having had a long hospitalization, having had avoidable hospitalizations, and having high-risk health conditions. We found that autistic adults had higher odds of living in a residential facility, receiving in-home services from outside caregivers, having had an avoidable hospitalization, and having a high-risk health condition, compared to neurotypical adults without mental health conditions. Adults with intellectual disability had similar odds of having these conditions. Adults with other mental health conditions were also more likely to live in a residential facility, receive services from outside caregivers, and have had avoidable hospitalizations compared to the neurotypical population without mental health conditions. They had three times higher odds of having a high-risk health condition. High risk of COVID-19 among autistic adults and adults with intellectual disability and mental health conditions should be recognized by clinicians, and these groups should be prioritized for vaccine outreach. En ligne : https://dx.doi.org/10.1177/13623613211039662 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=473

Disparities by Race and Ethnicity in Inpatient Hospitalizations Among Autistic Adults / Jessica E. RAST in Journal of Autism and Developmental Disorders, 54-5 (May 2024)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 54-5 (May 2024) . - p.1672-1679 Titre : Disparities by Race and Ethnicity in Inpatient Hospitalizations Among Autistic Adults Type de document : texte imprimé Auteurs : Jessica E. RAST, Auteur ; Sherira J. FERNANDES, Auteur ; Whitney SCHOTT, Auteur ; Lindsay L. SHEA, Auteur Article en page(s) : p.1672-1679 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : This study examined hospitalizations in a large, all-payer, nationally representative sample of inpatient hospitalizations in the US and identified differences in rates of hospitalization for conditions by race and ethnicity in autistic adults. Conditions examined included mood disorders, epilepsy, schizophrenia, and ambulatory care sensitive conditions (ACSCs). Compared to white, non-Hispanic autistic adults, Black, Hispanic, Asian or Pacific Islander (API), and autistic adults of another race had lower prevalence of admission for a principal diagnosis of a mood disorder. Conversely, Black, Hispanic, API, and autistic adults of another race had higher odds of admission for epilepsy than white autistic adults. Black and Hispanic autistic adults were more likely to have schizophrenia as a principal diagnosis compared to white autistic adults, but only Black autistic adults had increased odds for admission for an ACSCs compared to white autistic adults. Differences in diagnosis prevalence among hospitalized autistic adults may suggest differential access to comprehensive outpatient care that could prevent such hospitalizations, while also pointing to concerns of differential validity of diagnostic tools and treatment approaches. Insurance policy and programs should prioritize optimizing outpatient care to ensure access to care and emphasize the need for equitable treatment. En ligne : https://doi.org/10.1007/s10803-023-05911-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=530 [article] Disparities by Race and Ethnicity in Inpatient Hospitalizations Among Autistic Adults [texte imprimé] / Jessica E. RAST, Auteur ; Sherira J. FERNANDES, Auteur ; Whitney SCHOTT, Auteur ; Lindsay L. SHEA, Auteur . - p.1672-1679. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 54-5 (May 2024) . - p.1672-1679 Index. décimale : PER Périodiques Résumé : This study examined hospitalizations in a large, all-payer, nationally representative sample of inpatient hospitalizations in the US and identified differences in rates of hospitalization for conditions by race and ethnicity in autistic adults. Conditions examined included mood disorders, epilepsy, schizophrenia, and ambulatory care sensitive conditions (ACSCs). Compared to white, non-Hispanic autistic adults, Black, Hispanic, Asian or Pacific Islander (API), and autistic adults of another race had lower prevalence of admission for a principal diagnosis of a mood disorder. Conversely, Black, Hispanic, API, and autistic adults of another race had higher odds of admission for epilepsy than white autistic adults. Black and Hispanic autistic adults were more likely to have schizophrenia as a principal diagnosis compared to white autistic adults, but only Black autistic adults had increased odds for admission for an ACSCs compared to white autistic adults. Differences in diagnosis prevalence among hospitalized autistic adults may suggest differential access to comprehensive outpatient care that could prevent such hospitalizations, while also pointing to concerns of differential validity of diagnostic tools and treatment approaches. Insurance policy and programs should prioritize optimizing outpatient care to ensure access to care and emphasize the need for equitable treatment. En ligne : https://doi.org/10.1007/s10803-023-05911-0 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=530

Prevalence of high-risk conditions for severe COVID-19 among Medicaid-enrolled children with autism and mental health diagnoses in the United States / Whitney SCHOTT in Autism, 27-7 (October 2023)  

Public ISBD [article]  inAutism > 27-7 (October 2023) . - p.2145-2157 Titre : Prevalence of high-risk conditions for severe COVID-19 among Medicaid-enrolled children with autism and mental health diagnoses in the United States Type de document : texte imprimé Auteurs : Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay L. SHEA, Auteur Article en page(s) : p.2145-2157 Langues : Anglais (eng) Mots-clés : autism spectrum disorders  COVID-19  medical comorbidity Index. décimale : PER Périodiques Résumé : Children are at risk of short- and long-term morbidity and mortality from COVID-19. We examine whether autistic children and children with mental health conditions have higher odds of underlying health conditions at high risk of severe disease from COVID-19. We use claims data from a national sample of Medicaid-enrolled children for the years 2008-2016. We examine (1) children with claims for autism and (2) a random sample of children covered by Medicaid, without autism claims but with mental health condition. The comparison group is a random sample of children without autism or any mental health condition. There were 888,487 autistic children, 423,397 with mental health conditions (but not autism or intellectual disability), and 932,625 children without autism or mental health condition. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had higher odds of having any underlying condition (odds ratio=2.17; 99% confidence interval=2.14-2.20), as did children with mental health conditions (odds ratio=1.71; 99% confidence interval=1.68-1.73), adjusting for basic demographic characteristics. Children with diagnoses of autism and mental health conditions may be at higher risk for severe COVID due to high-risk condition prevalence.Lay abstractChildren are at risk of varying severity of illness and even death from COVID-19. We aim to determine whether autistic children or children with mental health conditions have more underlying health conditions that put people at risk of severe illness from COVID-19. We use data from a national sample of Medicaid-enrolled children for the years 2008-2016. These data include children across the 50 states and the District of Columbia. We compare the prevalence of underlying conditions among autistic children and children with mental health condition to that of other children in Medicaid. This study included 888,487 autistic children, 423,397 with any mental health condition (but not autism), and 932,625 children without any of these diagnoses. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had over twice the odds of having any underlying conditions, when accounting for age, race, sex, and other characteristics. Children with mental health conditions had 70% higher odds of having these underlying conditions. Mitigation measures in schools and other areas could minimize risk of short- and long-term impacts from COVID for autistic and all children. En ligne : http://dx.doi.org/10.1177/13623613231155265 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510 [article] Prevalence of high-risk conditions for severe COVID-19 among Medicaid-enrolled children with autism and mental health diagnoses in the United States [texte imprimé] / Whitney SCHOTT, Auteur ; Sha TAO, Auteur ; Lindsay L. SHEA, Auteur . - p.2145-2157. Langues : Anglais (eng) in Autism > 27-7 (October 2023) . - p.2145-2157 Mots-clés : autism spectrum disorders  COVID-19  medical comorbidity Index. décimale : PER Périodiques Résumé : Children are at risk of short- and long-term morbidity and mortality from COVID-19. We examine whether autistic children and children with mental health conditions have higher odds of underlying health conditions at high risk of severe disease from COVID-19. We use claims data from a national sample of Medicaid-enrolled children for the years 2008-2016. We examine (1) children with claims for autism and (2) a random sample of children covered by Medicaid, without autism claims but with mental health condition. The comparison group is a random sample of children without autism or any mental health condition. There were 888,487 autistic children, 423,397 with mental health conditions (but not autism or intellectual disability), and 932,625 children without autism or mental health condition. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had higher odds of having any underlying condition (odds ratio=2.17; 99% confidence interval=2.14-2.20), as did children with mental health conditions (odds ratio=1.71; 99% confidence interval=1.68-1.73), adjusting for basic demographic characteristics. Children with diagnoses of autism and mental health conditions may be at higher risk for severe COVID due to high-risk condition prevalence.Lay abstractChildren are at risk of varying severity of illness and even death from COVID-19. We aim to determine whether autistic children or children with mental health conditions have more underlying health conditions that put people at risk of severe illness from COVID-19. We use data from a national sample of Medicaid-enrolled children for the years 2008-2016. These data include children across the 50 states and the District of Columbia. We compare the prevalence of underlying conditions among autistic children and children with mental health condition to that of other children in Medicaid. This study included 888,487 autistic children, 423,397 with any mental health condition (but not autism), and 932,625 children without any of these diagnoses. We found 29.5% of autistic children and 25.2% of children with mental health conditions had an underlying condition with high risk for severe illness from COVID, compared to 14.1% of children without these diagnoses. Autistic children had over twice the odds of having any underlying conditions, when accounting for age, race, sex, and other characteristics. Children with mental health conditions had 70% higher odds of having these underlying conditions. Mitigation measures in schools and other areas could minimize risk of short- and long-term impacts from COVID for autistic and all children. En ligne : http://dx.doi.org/10.1177/13623613231155265 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=510

Psychotropic Medication Use in Children and Youth with Autism Enrolled in Medicaid / Jessica E. RAST ; Sha TAO ; Whitney SCHOTT ; Lindsay L. SHEA ; Edward S. BRODKIN ; Connor M. KERNS ; Charles E. LEONARD ; Michael J. MURRAY ; Brian K. LEE in Journal of Autism and Developmental Disorders, 55-1 (January 2025)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 55-1 (January 2025) . - p.258-266 Titre : Psychotropic Medication Use in Children and Youth with Autism Enrolled in Medicaid : Journal of Autism and Developmental Disorders Type de document : texte imprimé Auteurs : Jessica E. RAST, Auteur ; Sha TAO, Auteur ; Whitney SCHOTT, Auteur ; Lindsay L. SHEA, Auteur ; Edward S. BRODKIN, Auteur ; Connor M. KERNS, Auteur ; Charles E. LEONARD, Auteur ; Michael J. MURRAY, Auteur ; Brian K. LEE, Auteur Article en page(s) : p.258-266 Langues : Anglais (eng) Index. décimale : PER Périodiques Résumé : Children with autism frequently present with complex mental health diagnoses and psychotropic medications are often a component of comprehensive biopsychosocial treatment plans for these conditions. The purpose of this study is to provide rates and patterns of psychotropic medication use, and predictors thereof, in children and youth with autism enrolled in Medicaid across the US. This study examined national Medicaid claims from 2008 to 2016 of all children and youth with autism ages 0-21 years enrolled in Medicaid. Psychotropic medication use was examined across several child and youth characteristics, including age, co-occurring mental health conditions, sex, and race and ethnicity. About half of children and youth with autism enrolled in Medicaid had at least one psychotropic prescription in a year, a number that decreased slightly across the study period due to decreases in the prescription of antipsychotics. As new medications for autism or co-occurring conditions are developed and deployed, and as the understanding of the characteristics of the population of children with autism evolves, studying rates of medication usage helps to understand utilization patterns and differences in access to quality care. En ligne : https://doi.org/10.1007/s10803-023-06182-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=546 [article] Psychotropic Medication Use in Children and Youth with Autism Enrolled in Medicaid : Journal of Autism and Developmental Disorders [texte imprimé] / Jessica E. RAST, Auteur ; Sha TAO, Auteur ; Whitney SCHOTT, Auteur ; Lindsay L. SHEA, Auteur ; Edward S. BRODKIN, Auteur ; Connor M. KERNS, Auteur ; Charles E. LEONARD, Auteur ; Michael J. MURRAY, Auteur ; Brian K. LEE, Auteur . - p.258-266. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 55-1 (January 2025) . - p.258-266 Index. décimale : PER Périodiques Résumé : Children with autism frequently present with complex mental health diagnoses and psychotropic medications are often a component of comprehensive biopsychosocial treatment plans for these conditions. The purpose of this study is to provide rates and patterns of psychotropic medication use, and predictors thereof, in children and youth with autism enrolled in Medicaid across the US. This study examined national Medicaid claims from 2008 to 2016 of all children and youth with autism ages 0-21 years enrolled in Medicaid. Psychotropic medication use was examined across several child and youth characteristics, including age, co-occurring mental health conditions, sex, and race and ethnicity. About half of children and youth with autism enrolled in Medicaid had at least one psychotropic prescription in a year, a number that decreased slightly across the study period due to decreases in the prescription of antipsychotics. As new medications for autism or co-occurring conditions are developed and deployed, and as the understanding of the characteristics of the population of children with autism evolves, studying rates of medication usage helps to understand utilization patterns and differences in access to quality care. En ligne : https://doi.org/10.1007/s10803-023-06182-5 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=546

Service Use and Unmet Needs Among Adults with Autism Awaiting Home- and Community-Based Medicaid Services / Whitney SCHOTT in Journal of Autism and Developmental Disorders, 51-4 (April 2021)  

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