Table 1.
Demographics, clinical characteristics, and outcomes for matched cohort of autistic and non-autistic Medicare beneficiaries
| Non-autistic older adults (n=1,614) |
Autistic older adultsa (n=1,614) |
Total (N=3,228) |
Effect Sizeb | |
|---|---|---|---|---|
| Demographics | ||||
| Age, n(%) | 0.08 | |||
| 65–69 | 996 (61.71%) | 1,041 (64.50%) | 2,037 (63.10%) | |
| 70–74 | 359 (22.24%) | 274 (16.98%) | 633 (19.61%) | |
| 75+ | 259 (16.05%) | 299 (18.53%) | 558 (17.29%) | |
| Male, n (%) | 1,067 (66.11%) | 1,067 (66.11%) | 2,134 (66.11%) | <0.01 |
| Race and Ethnicity, n (%) | <0.01 | |||
| White, non-Hispanic | 1,492 (92.44%) | 1,492 (92.44%) | 2,984 (92.44%) | |
| Black, non-Hispanic | 64 (3.97%) | 64 (3.97%) | 128 (3.97%) | |
| Hispanic | 12 (0.74%) | 12 (0.74%) | 24 (0.74%) | |
| Other | 46 (2.85%) | 46 (2.85%) | 92 (2.85%) | |
| Region, n (%) | 0.08 | |||
| Midwest | 321 (19.89%) | 408 (25.28%) | 729 (22.58%) | |
| Northeast | 472 (29.24%) | 423 (26.21%) | 895 (27.73%) | |
| Other | 313 (19.39%) | 305(18.90%) | 618 (19.14%) | |
| South | 508 (31.47%) | 478 (29.62%) | 986 (30.55%) | |
| Rurality, n (%) | ||||
| Large Metro Area (>1,000,000) | 781 (48.39%) | 811 (50.25%) | 1,592 (49.32%) | 0.13 |
| Small Metro Area (<1,000,000) | 459 (28.44%) | 549 (34.01%) | 1,008 (31.23%) | |
| Metro Area Adjacent | 174 (10.78%) | 163 (10.10%) | 337 (10.44%) | |
| Non-Metro Area (>2,500) | 131 (8.12%) | 70 (4.34%) | 201 (6.23%) | |
| Rural Area (<2,500) | 69 (4.28%) | 21 (1.30%) | 90 (2.79%) | |
| Estimated Household Income,c median (IQR)d | 40.83 (34.92, 48.40) | 41.62 (35.72, 49.14) | 41.11 (35.43, 48.78) | 0.08 |
| Dual Eligible,e n (%) | 119 (11.94%) | 587 (58.88%) | 706 (35.41%) | 0.49 |
| HMOf Status, n (%) | 1,158 (71.75%) | 129 (7.99%) | 1,287 (39.87%) | −0.65 |
| Hospitalization Year, median (IQR) | 2014 (2013, 2016) | 2014 (2013, 2017) | 2014 (2013, 2016) | 0.02 |
| CCI,g median (IQR) | 0 (0, 2) | 0 (0, 2) | 0 (0, 2) | <0.01 |
| VA-Frailty Score,h median (IQR) | 0.19 (0.10, 0.32) | 0.23 (0.13, 0.32) | 0.23 (0.13, 0.32) | 0.14 |
| History of Insomnia,i n (%) | 281 (17.41%) | 306 (18.96%) | 587 (18.18%) | 0.02 |
| History of Any Mental Health Condition,i n (%) | 1,066 (66.05%) | 1,326 (82.16%) | 2,392 (74.10%) | 0.18 |
| Outcomes | ||||
| Length of Stay, median (IQR) | 4 (2, 7) | 4 (3, 7) | 4 (2, 7) | 0.06 |
| Receipt of OT,j n (%) | 734 (45.48%) | 733 (45.42%) | 1,467 (45.45%) | <0.01 |
| Receipt of PT,k n (%) | 1,145 (70.94%) | 1,158 (71.75%) | 2,303 (71.34%) | <0.01 |
| Discharged Home, n (%) | 810 (50.19%) | 495 (30.67%) | 1,305 (40.44%) | −0.20 |
| Discharged to SNF,l n (%) | 455 (28.19%) | 706 (43.74%) | 1,161 (35.97%) | 0.16 |
| Discharged to Inpatient Rehabilitation, n (%) | 125 (7.74%) | 84 (5.20%) | 209 (6.47%) | −0.05 |
| Readmission,m n (%) | 760 (47.09%) | 1,001 (62.02%) | 1,761 (54.55%) | 0.15 |
Autism diagnoses were identified by at least one inpatient or outpatient encounter with ICD-9 codes 299.0x, 299.9x or ICD-10 codes F84.0, F84.1, F84.5, or F84.9;
Effect sizes were calculated as Cohen’s d for continuous variables, Phi coefficient for binary variables and Cramer’s v for categorical variables;
Estimated annual household income is reported in tens of thousands and was estimated based on county, year, and U.S. Census Bureau information;
IQR=Interquartile Range;
Dual Medicaid and Medicare enrollment status was only collected from 2016 through 2021 and thus was only available for participants with first observed fall-related hospitalizations during those years;
HMO=Healthcare Management Organization;
CCI=Charlson Comorbidity Index;
VA-Fraily Score=Veterans Affairs Frailty Score;
History of insomnia and history of any mental health condition prior to first observed fall-related hospitalization were identified using the Healthcare Cost and Utilization Project’s (HCUP) Clinical Classifications Software Refined (CCSR) for ICD-10 and General Equivalence Mapping to identify corresponding ICD-9 codes;
OT=Occupational Therapy, which was identified via revenue center codes 0430–0433, 0439, 0978;
PT=Physical Therapy, which was identified via revenue codes 0420–0423, 0429, 0977;
SNF=Skilled Nursing Facility;
All-cause 30-day inpatient readmission