Health service utilization among autistic youth in Aotearoa New Zealand: A nationwide cross-sectional study / Laurie K MCLAY in Autism, 29-5 (May 2025)  

Public ISBD [article]  inAutism > 29-5 (May 2025) . - p.1143-1156 Titre : Health service utilization among autistic youth in Aotearoa New Zealand: A nationwide cross-sectional study Type de document : Texte imprimé et/ou numérique Auteurs : Laurie K MCLAY, Auteur ; Philip J SCHLUTER, Auteur ; John WILLIAMS, Auteur ; Francesca ANNS, Auteur ; Ruth MONK, Auteur ; Joanne DACOMBE, Auteur ; Gabrielle HOGG, Auteur ; Jessica TUPOU, Auteur ; Troy RUHE, Auteur ; Taylor Scott, Auteur ; Emma WOODFORD, Auteur ; Hiran THABREW, Auteur ; Nicholas BOWDEN, Auteur Article en page(s) : p.1143-1156 Langues : Anglais (eng) Mots-clés : autism  co-occurring conditions  health  health service use  mental health  pharmaceutical dispensing  youth Index. décimale : PER Périodiques Résumé : Many autistic youth have complex healthcare needs, resulting in high rates of health service utilization. However, many characteristics of this health service utilization remain unknown. Using whole-of-population data, this study aimed to quantify and compare rates of psychiatric and non-psychiatric health service utilization among autistic and non-autistic youth, with and without co-occurring intellectual disability. A national retrospective cohort study was employed using linked individual-level administrative data for Aotearoa New Zealand youth (aged 0-24?years). Health service utilization outcomes included 11 psychiatric and non-psychiatric domains. Propensity score matching on a range of sociodemographic measures compared groups across health service utilization outcomes. Data were obtained for 19,479 autistic youth, 29% of whom had a co-occurring intellectual disability and 1,561,278 non-autistic youth. Results demonstrated higher rates of mental health service utilization among autistic compared with non-autistic youth, including inpatient (prevalence ratio 5.85; 95% confidence interval 4.93-6.94) and outpatient (prevalence ratio 4.96; 95% confidence interval 4.75-5.18) service use and psychotropic medication dispensing (prevalence ratio 6.83; 95% confidence interval 6.65-7.02), particularly among autistic youth without intellectual disability. Rates of non-psychiatric hospital admissions (prevalence ratio 1.93; 95% confidence interval 1.85-2.01), potentially avoidable hospitalizations (prevalence ratio 1.91; 95% confidence interval 1.82-2.00) and outpatient visits (prevalence ratio 1.99; 95% confidence interval 1.95-2.01) were also higher among autistic youth. Research implications for delivery of healthcare services are discussed.Lay abstract Autistic youth generally use healthcare services more often than non-autistic youth. However, we know very little about the factors that can affect health service use and the types of services that are used, and this has not been explored in Aotearoa New Zealand. We analysed data from New Zealand to compare health service use among autistic and non-autistic youth (0 to 24-year-olds). Data were available for 19,479 autistic youth and 1,561,278 non-autistic youth. We compared hospitalizations, specialist visits, emergency department visits and use of different types of medications. In this study, autistic youth were found to have been hospitalized for medical and mental health reasons, more often than non-autistic youth. Autistic youth were also more likely to have attended specialist appointments and to have been given medication. These differences were particularly large for medications commonly used for mental health conditions (e.g. anxiety, depression, attention deficit hyperactivity disorder) or associated symptoms. Autistic youth who also had an intellectual disability were more likely to use healthcare services for physical health conditions, but were less likely to use mental health services, when compared with autistic youth who did not have an intellectual disability. These findings, along with other research, suggest that the healthcare needs of autistic youth are not always being met. Further work is needed to enhance our understanding of co-occurring conditions among autistic youth, including those that result in high rates of health service use, in order to inform the development of healthcare services and training for healthcare professionals to better cater to the needs of autistic youth. En ligne : https://dx.doi.org/10.1177/13623613241298352 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=555 [article] Health service utilization among autistic youth in Aotearoa New Zealand: A nationwide cross-sectional study [Texte imprimé et/ou numérique] / Laurie K MCLAY, Auteur ; Philip J SCHLUTER, Auteur ; John WILLIAMS, Auteur ; Francesca ANNS, Auteur ; Ruth MONK, Auteur ; Joanne DACOMBE, Auteur ; Gabrielle HOGG, Auteur ; Jessica TUPOU, Auteur ; Troy RUHE, Auteur ; Taylor Scott, Auteur ; Emma WOODFORD, Auteur ; Hiran THABREW, Auteur ; Nicholas BOWDEN, Auteur . - p.1143-1156. Langues : Anglais (eng) in Autism > 29-5 (May 2025) . - p.1143-1156 Mots-clés : autism  co-occurring conditions  health  health service use  mental health  pharmaceutical dispensing  youth Index. décimale : PER Périodiques Résumé : Many autistic youth have complex healthcare needs, resulting in high rates of health service utilization. However, many characteristics of this health service utilization remain unknown. Using whole-of-population data, this study aimed to quantify and compare rates of psychiatric and non-psychiatric health service utilization among autistic and non-autistic youth, with and without co-occurring intellectual disability. A national retrospective cohort study was employed using linked individual-level administrative data for Aotearoa New Zealand youth (aged 0-24?years). Health service utilization outcomes included 11 psychiatric and non-psychiatric domains. Propensity score matching on a range of sociodemographic measures compared groups across health service utilization outcomes. Data were obtained for 19,479 autistic youth, 29% of whom had a co-occurring intellectual disability and 1,561,278 non-autistic youth. Results demonstrated higher rates of mental health service utilization among autistic compared with non-autistic youth, including inpatient (prevalence ratio 5.85; 95% confidence interval 4.93-6.94) and outpatient (prevalence ratio 4.96; 95% confidence interval 4.75-5.18) service use and psychotropic medication dispensing (prevalence ratio 6.83; 95% confidence interval 6.65-7.02), particularly among autistic youth without intellectual disability. Rates of non-psychiatric hospital admissions (prevalence ratio 1.93; 95% confidence interval 1.85-2.01), potentially avoidable hospitalizations (prevalence ratio 1.91; 95% confidence interval 1.82-2.00) and outpatient visits (prevalence ratio 1.99; 95% confidence interval 1.95-2.01) were also higher among autistic youth. Research implications for delivery of healthcare services are discussed.Lay abstract Autistic youth generally use healthcare services more often than non-autistic youth. However, we know very little about the factors that can affect health service use and the types of services that are used, and this has not been explored in Aotearoa New Zealand. We analysed data from New Zealand to compare health service use among autistic and non-autistic youth (0 to 24-year-olds). Data were available for 19,479 autistic youth and 1,561,278 non-autistic youth. We compared hospitalizations, specialist visits, emergency department visits and use of different types of medications. In this study, autistic youth were found to have been hospitalized for medical and mental health reasons, more often than non-autistic youth. Autistic youth were also more likely to have attended specialist appointments and to have been given medication. These differences were particularly large for medications commonly used for mental health conditions (e.g. anxiety, depression, attention deficit hyperactivity disorder) or associated symptoms. Autistic youth who also had an intellectual disability were more likely to use healthcare services for physical health conditions, but were less likely to use mental health services, when compared with autistic youth who did not have an intellectual disability. These findings, along with other research, suggest that the healthcare needs of autistic youth are not always being met. Further work is needed to enhance our understanding of co-occurring conditions among autistic youth, including those that result in high rates of health service use, in order to inform the development of healthcare services and training for healthcare professionals to better cater to the needs of autistic youth. En ligne : https://dx.doi.org/10.1177/13623613241298352 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=555

Is parent education a factor in identifying autism/takiw?tanga in an ethnic cohort of Pacific children in Aotearoa, New Zealand? A national cross-sectional study using linked administrative data / Betty KOLOSE-PULEFOLAU ; Troy RUHE ; Faith ALDRIDGE ; Siale FOLIAKI ; Liam KOKAUA ; Talai MAPUSUA ; Joanne DACOMBE ; Rosalina RICHARDS ; Russell BLAKELOCK ; Nicholas BOWDEN in Autism, 28-7 (July 2024)  

Public ISBD [article]  inAutism > 28-7 (July 2024) . - p.1667-1676 Titre : Is parent education a factor in identifying autism/takiw?tanga in an ethnic cohort of Pacific children in Aotearoa, New Zealand? A national cross-sectional study using linked administrative data Type de document : Texte imprimé et/ou numérique Auteurs : Betty KOLOSE-PULEFOLAU, Auteur ; Troy RUHE, Auteur ; Faith ALDRIDGE, Auteur ; Siale FOLIAKI, Auteur ; Liam KOKAUA, Auteur ; Talai MAPUSUA, Auteur ; Joanne DACOMBE, Auteur ; Rosalina RICHARDS, Auteur ; Russell BLAKELOCK, Auteur ; Nicholas BOWDEN, Auteur Article en page(s) : p.1667-1676 Langues : Anglais (eng) Mots-clés : autism  Pacific ethnicity  parental education  population data Index. décimale : PER Périodiques Résumé : Studies have found early detection of autism is protective for an individual and their family. Fewer Pacific children are diagnosed with autism compared with non-Pacific children, and those who have significantly higher needs, suggesting an undercount of those diagnosed. The purpose of this study was to explore any association between parental education and autism in Pacific children living in Aotearoa, New Zealand. This was a national cross-sectional study using data from New Zealand?s Integrated Data Infrastructure, including Pacific and non-M?ori non-Pacific children in the 2013 Census. A novel method was employed to capture autism, while years of parents' education was estimated from their highest attained qualification level. Apposite regression models were used to analyse the relationship between parental education and autism. We found that autism was identified in 1.1% of Pacific children compared with 1.6% of non-M?ori, non-Pacific children. A year of education among parents of Pacific children was associated with increased identification of autism (odds ratio = 1.10; 95% confidence interval = 1.06-1.15). The findings show education plays a positive role in receiving a diagnosis for Pacific autistic children but suggest a systemic failure to support Pacific parents to navigate existing health systems for themselves or their children. Lay abstract Previous studies of autism in Aotearoa, New Zealand, suggest that fewer Pacific children receive an autism diagnosis compared to European children. This study aimed to explore if formal education qualification of parents is related to receiving an autism diagnosis for their Pacific child. Our findings show that autism was identified in 1.1% of Pacific children compared with 1.6% among non-M?ori, non-Pacific children. Parents with higher levels of education were more likely to receive an autism diagnosis for their Pacific child. While the study findings indicate education plays a positive role in receiving a diagnosis for autistic children, they suggest a systemic failure of supporting Pacific parents and communities to navigate the health and education systems that exist in Aotearoa, New Zealand. En ligne : https://dx.doi.org/10.1177/13623613231217800 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=531 [article] Is parent education a factor in identifying autism/takiw?tanga in an ethnic cohort of Pacific children in Aotearoa, New Zealand? A national cross-sectional study using linked administrative data [Texte imprimé et/ou numérique] / Betty KOLOSE-PULEFOLAU, Auteur ; Troy RUHE, Auteur ; Faith ALDRIDGE, Auteur ; Siale FOLIAKI, Auteur ; Liam KOKAUA, Auteur ; Talai MAPUSUA, Auteur ; Joanne DACOMBE, Auteur ; Rosalina RICHARDS, Auteur ; Russell BLAKELOCK, Auteur ; Nicholas BOWDEN, Auteur . - p.1667-1676. Langues : Anglais (eng) in Autism > 28-7 (July 2024) . - p.1667-1676 Mots-clés : autism  Pacific ethnicity  parental education  population data Index. décimale : PER Périodiques Résumé : Studies have found early detection of autism is protective for an individual and their family. Fewer Pacific children are diagnosed with autism compared with non-Pacific children, and those who have significantly higher needs, suggesting an undercount of those diagnosed. The purpose of this study was to explore any association between parental education and autism in Pacific children living in Aotearoa, New Zealand. This was a national cross-sectional study using data from New Zealand?s Integrated Data Infrastructure, including Pacific and non-M?ori non-Pacific children in the 2013 Census. A novel method was employed to capture autism, while years of parents' education was estimated from their highest attained qualification level. Apposite regression models were used to analyse the relationship between parental education and autism. We found that autism was identified in 1.1% of Pacific children compared with 1.6% of non-M?ori, non-Pacific children. A year of education among parents of Pacific children was associated with increased identification of autism (odds ratio = 1.10; 95% confidence interval = 1.06-1.15). The findings show education plays a positive role in receiving a diagnosis for Pacific autistic children but suggest a systemic failure to support Pacific parents to navigate existing health systems for themselves or their children. Lay abstract Previous studies of autism in Aotearoa, New Zealand, suggest that fewer Pacific children receive an autism diagnosis compared to European children. This study aimed to explore if formal education qualification of parents is related to receiving an autism diagnosis for their Pacific child. Our findings show that autism was identified in 1.1% of Pacific children compared with 1.6% among non-M?ori, non-Pacific children. Parents with higher levels of education were more likely to receive an autism diagnosis for their Pacific child. While the study findings indicate education plays a positive role in receiving a diagnosis for autistic children, they suggest a systemic failure of supporting Pacific parents and communities to navigate the health and education systems that exist in Aotearoa, New Zealand. En ligne : https://dx.doi.org/10.1177/13623613231217800 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=531

Mortality risk among Autistic children and young people: A nationwide birth cohort study / Nicholas BOWDEN ; Sheree GIBB ; Richard AUDAS ; Joanne DACOMBE ; Laurie MCLAY ; Andrew SPORLE ; Hilary STACE ; Barry TAYLOR ; Hiran THABREW ; Reremoana THEODORE ; Jessica TUPOU ; Philip J. SCHLUTER in Autism, 28-9 (September 2024)  

Public ISBD [article]  inAutism > 28-9 (September 2024) . - p.2244-2253 Titre : Mortality risk among Autistic children and young people: A nationwide birth cohort study Type de document : Texte imprimé et/ou numérique Auteurs : Nicholas BOWDEN, Auteur ; Sheree GIBB, Auteur ; Richard AUDAS, Auteur ; Joanne DACOMBE, Auteur ; Laurie MCLAY, Auteur ; Andrew SPORLE, Auteur ; Hilary STACE, Auteur ; Barry TAYLOR, Auteur ; Hiran THABREW, Auteur ; Reremoana THEODORE, Auteur ; Jessica TUPOU, Auteur ; Philip J. SCHLUTER, Auteur Article en page(s) : p.2244-2253 Langues : (en) Mots-clés : adolescents  autism spectrum disorders  health services  medical comorbidity  pre-school children  school-age children  social services Index. décimale : PER Périodiques Résumé : Autism has been associated with increased mortality risk among adult populations, but little is known about the mortality risk among children and young people (0-24?years). We used a 15-year nationwide birth cohort study using linked health and non-health administrative data to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. Time-to-event analysis was used to determine the association between autism and mortality, controlling for sex, age, ethnicity, deprivation and rurality of residence. The participant population included 895,707 children of whom 11,919 (1.4%) were identified as Autistic. Autism was associated with a significantly higher mortality risk (hazard ratio = 2.35; 95% confidence interval = 1.80-3.06) compared to the general population. In addition, using stratified analyses, we found that this risk was significantly higher among females (hazard ratio = 5.40; 95% confidence interval = 3.42-8.52) compared to males (hazard ratio = 1.82; 95% confidence interval = 1.32-2.52). We also determined that among Autistic young people, mortality risk was significantly higher for those with a co-occurring intellectual disability (hazard ratio = 2.02; 95% confidence interval = 1.17-3.46). In this study, autism was associated with higher mortality in children and young people compared to the non-Autistic population. Increased efforts are required to better meet the health needs of this population. Lay abstract Existing literature indicates that Autistic people have shorter life expectancy, but little is known about the mortality risk among Autistic children and young people (0-24?years). We used a 15-year nationwide birth cohort study to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. The study included 895,707 children and 11,919 (1.4%) were Autistic. We found that autism was associated with a significantly higher mortality risk compared to the non-Autistic population. In addition, we found that this risk was significantly higher among females compared to males and for those with a co-occurring intellectual disability. Increased efforts are required to better meet the health needs of this population. En ligne : https://dx.doi.org/10.1177/13623613231224015 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=535 [article] Mortality risk among Autistic children and young people: A nationwide birth cohort study [Texte imprimé et/ou numérique] / Nicholas BOWDEN, Auteur ; Sheree GIBB, Auteur ; Richard AUDAS, Auteur ; Joanne DACOMBE, Auteur ; Laurie MCLAY, Auteur ; Andrew SPORLE, Auteur ; Hilary STACE, Auteur ; Barry TAYLOR, Auteur ; Hiran THABREW, Auteur ; Reremoana THEODORE, Auteur ; Jessica TUPOU, Auteur ; Philip J. SCHLUTER, Auteur . - p.2244-2253. Langues : (en) in Autism > 28-9 (September 2024) . - p.2244-2253 Mots-clés : adolescents  autism spectrum disorders  health services  medical comorbidity  pre-school children  school-age children  social services Index. décimale : PER Périodiques Résumé : Autism has been associated with increased mortality risk among adult populations, but little is known about the mortality risk among children and young people (0-24?years). We used a 15-year nationwide birth cohort study using linked health and non-health administrative data to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. Time-to-event analysis was used to determine the association between autism and mortality, controlling for sex, age, ethnicity, deprivation and rurality of residence. The participant population included 895,707 children of whom 11,919 (1.4%) were identified as Autistic. Autism was associated with a significantly higher mortality risk (hazard ratio = 2.35; 95% confidence interval = 1.80-3.06) compared to the general population. In addition, using stratified analyses, we found that this risk was significantly higher among females (hazard ratio = 5.40; 95% confidence interval = 3.42-8.52) compared to males (hazard ratio = 1.82; 95% confidence interval = 1.32-2.52). We also determined that among Autistic young people, mortality risk was significantly higher for those with a co-occurring intellectual disability (hazard ratio = 2.02; 95% confidence interval = 1.17-3.46). In this study, autism was associated with higher mortality in children and young people compared to the non-Autistic population. Increased efforts are required to better meet the health needs of this population. Lay abstract Existing literature indicates that Autistic people have shorter life expectancy, but little is known about the mortality risk among Autistic children and young people (0-24?years). We used a 15-year nationwide birth cohort study to estimate the mortality risk among Autistic children and young people in Aotearoa/New Zealand. The study included 895,707 children and 11,919 (1.4%) were Autistic. We found that autism was associated with a significantly higher mortality risk compared to the non-Autistic population. In addition, we found that this risk was significantly higher among females compared to males and for those with a co-occurring intellectual disability. Increased efforts are required to better meet the health needs of this population. En ligne : https://dx.doi.org/10.1177/13623613231224015 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=535

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