Table 5.
Odds ratios, 95% CIs, parameter estimates, and SEs for healthcare utilization and expenditures; adults with and without ASD matched on age, race, and gender (n = 7092).
| Utilization | ⩾4 OT visits
|
>1 IP visit
|
>1 ER visit
|
⩾18 Rx claims
|
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | AOR | 95% CI | ||||
| ASD | |||||||||||
| Yes | 2.73*** | (2.31, 3.22) | 0.70* | (0.51, 0.96) | 0.76** | (0.61, 0.93) | 4.79*** | (4.09, 5.60) | |||
| No | |||||||||||
| ASD vs no ASD | |||||||||||
| ASD*psych vs NoASD*psych | 3.05*** | (2.49, 3.73) | 0.61** | (0.44, 0.84) | 0.71** | (0.56, 0.88) | 3.87*** | (3.23, 4.65) | |||
| ASD*nonpsych vs NoASD*Nonpsych | 2.48*** | (1.91, 3.22) | 0.78 | (0.54, 1.13) | 0.92 | (0.70, 1.20) | 5.43*** | (4.19, 7.04) | |||
| Within ASD | |||||||||||
| ASD*psych vs ASD*nopsych | 3.30*** | (2.43, 4.49) | 1.70 | (0.59, 4.88) | 1.49 | (0.91, 2.47) | 2.08*** | (1.53, 2.84) | |||
| ASD_nonpsych vs ASD*noNonpsych | 1.44* | (1.08, 1.93) | 1.57 | (0.92, 2.68) | 1.96*** | (1.41, 2.72) | 1.99*** | (1.49, 2.66) | |||
|
| |||||||||||
| Expenditures | OT
|
IP
|
ER
|
Rx
|
Total
|
Total expenditures in 2008 adjusted dollars |
|||||
| Beta | SE | Beta | SE | Beta | SE | Beta | SE | Beta | SE | ||
|
| |||||||||||
| Intercept | 6.28*** | 0.11 | 8.13*** | 0.18 | 7.83*** | 0.17 | 7.75*** | 0.11 | 8.02*** | 0.11 | US$3048 |
| ASD | |||||||||||
| Yes | 0.94*** | 0.05 | −0.20** | 0.08 | 1.51*** | 0.07 | 0.49*** | 0.04 | 0.32*** | 0.04 | US$4207 |
| No | |||||||||||
| ASD vs no ASD | Additional dollars | ||||||||||
| ASD*psych vs NoASD*psych | 1.14*** | 0.05 | −0.26** | 0.08 | 1.42*** | 0.08 | 0.32*** | 0.05 | 0.19*** | 0.05 | US$1800 |
| ASD*nonpsych vs NoASD*Nonpsych | 1.05*** | 0.06 | −0.18* | 0.09 | 1.58*** | 0.09 | 0.54*** | 0.06 | 0.40*** | 0.06 | US$4553 |
| Within ASD | |||||||||||
| ASD*psych vs ASD*nopsych | 1.54*** | 0.09 | 0.16 | 0.23 | 0.62*** | 0.17 | 0.17 | 0.09 | 0.65*** | 0.09 | US$4952 |
| ASD_nonpsych vs ASD*noNonpsych | 0.18** | 0.07 | 0.45*** | 0.13 | −0.16 | 0.11 | 0.17* | 0.07 | 0.46*** | 0.07 | US$5084 |
ASD: autism spectrum disorders; Rx: prescription drug; OT: outpatient visits; IP: inpatient hospitalizations; ER: emergency room; CI: confidence interval; SE: standard error.
Medicaid Analytic eXtract 2000–2008 (IL, NY, and TX).
Based on estimates for fee-for-service enrolled individuals aged 22–64 years with no Medicare coverage and alive in IL, NY, and TX Medicaid from 2000 to 2008.
AORs represent estimates from multinomial logistic regression analyses, respectively, after adjusting for cohort (before/after 2004), state, eligibility, county characteristics (metro status, median household income, above high school education, Primary Care Provider (PCP) shortage area, mental health specialist shortage area, and psychiatrist density), baseline Rx use, psychiatric comorbidity, and non-psychiatric comorbidity.
Parameter estimates represent results from generalized linear models with gamma distribution and log-link function after adjusting for cohort (before/after 2004), state, eligibility, county characteristics (metro status, median household income, above high school education, PCP shortage area, mental health specialist shortage area, and psychiatrist density), baseline Rx use, psychiatric comorbidity, and non-psychiatric comorbidity.
Model for IP expenditures was also adjusted for average length of stay.
Model for Rx and total expenditures was not adjusted for baseline prescription drug use due to high collinearity issues.
Total expenditures represents sum of OT, IP, and Rx expenditures.
Models 1, 2, and 3 represent separate regressions.
Total dollar = exponentiated (beta).
Additional Dollar = exponentiated (intercept)-exponentiated (beta) for each regression.
Sig.:
p < 0.001;
0.001 ≤ p < 0.01;
0.01 ≤ p < 0.05.