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Comorbidity and health services' usage in children with autism spectrum disorder: a nested case-control study

Epidemiology and psychiatric sciences, 2020-01, Vol.29, p.e95-e95, Article e95 [Peer Reviewed Journal]

Copyright Cambridge University Press 2020 ;The Author(s) 2020 2020 The Author(s) ;ISSN: 2045-7960 ;EISSN: 2045-7979 ;DOI: 10.1017/S2045796020000050 ;PMID: 31987063

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Title:
Comorbidity and health services' usage in children with autism spectrum disorder: a nested case-control study
Author: Dizitzer, Yotam ; Meiri, Gal ; Flusser, Hagit ; Michaelovski, Analya ; Dinstein, Ilan ; Menashe, Idan
Subjects: Anemia ; Attention deficit hyperactivity disorder ; Autism ; Autism Spectrum Disorder - diagnosis ; Autism Spectrum Disorder - epidemiology ; Autism Spectrum Disorder - therapy ; Cardiovascular diseases ; Case-Control Studies ; Child ; Children ; Classification ; Comorbidity ; Emergency medical services ; Emergency Service, Hospital - statistics & numerical data ; Expenditures ; Family medical history ; Female ; Females ; Health care ; Health care facilities ; Health services ; Health Services - statistics & numerical data ; Hearing loss ; Homogeneity ; Hospitals ; Humans ; Israel - epidemiology ; Male ; Males ; Medical records ; Medical Records - statistics & numerical data ; Medical referrals ; Minority & ethnic groups ; Multivariate analysis ; Original ; Population ; Prevalence ; Sex differences ; Sleep disorders ; Statistical analysis
Is Part Of: Epidemiology and psychiatric sciences, 2020-01, Vol.29, p.e95-e95, Article e95
Description: Children with autism spectrum disorder (ASD) tend to suffer from various medical comorbidities. We studied the comorbidity burden and health services' utilisation of children with ASD to highlight potential aetiologies and to better understand the medical needs of these children. In this nested case-control study, ASD cases and controls - matched by age, sex and ethnicity in a 1:5 ratio - were sampled from all children born between 2009 and 2016 at a tertiary medical centre. Data were obtained from the hospital's electronic database. Comorbid diagnoses were classified according to pathophysiological aetiology and anatomical/systemic classification of disease. Standard univariate and multivariate statistics were used to demonstrate comorbidities and health services' utilisation patterns that are significantly associated with ASD. ASD children had higher rates of comorbidities according to both pathophysiological and anatomical/systemic classifications (p < 0.001). The most marked significant differences were observed for: hearing impairments (OR = 4.728; 95% CI 2.207-10.127) and other auricular conditions (OR = 5.040; 95% CI 1.759-14.438); neurological (OR = 8.198; 95% CI 5.690-11.813) and ophthalmological (OR = 3.381; 95% CI 1.617-7.068) conditions; and ADD/ADHD (OR = 3.246; 95% CI 1.811-5.818). A subgroup analysis revealed a more profound case-control difference in anaemia rates among girls than in boys (OR = 3.25; 95% CI 1.04-10.19 v. OR = 0.74; 95% CI 0.33-1.64 respectively) and an opposite trend (larger differences in males than in females in cardiovascular diseases (OR = 1.99; 95% CI 1.23-3.23 v. OR = 0.76; 95% CI 0.17-3.45, respectively)). In addition, larger case-control differences were seen among Bedouin children than in Jewish children in a number of medical comorbidities (Breslow-Day test for homogeneity of odds ratio p-value <0.05). Finally, we found that children with ASD tended to be referred to the emergency department and to be admitted to the hospital more frequently than children without ASD, even after adjusting for their comorbidity burden (aOR = 1.28; 95% CI 1.08-1.50 and aOR = 1.28; 95% CI 1.11-1.47 for >1 referrals and admissions per year, respectively). The findings of this study contribute to the overall understanding of comorbid conditions and health services' utilisation for children with ASD. The higher prevalences of comorbidities and healthcare services' utilisation for children with ASD highlight the additional medical burden associated with this condition.
Publisher: England: Cambridge University Press
Language: English;Italian
Identifier: ISSN: 2045-7960
EISSN: 2045-7979
DOI: 10.1017/S2045796020000050
PMID: 31987063
Source: ProQuest One Psychology
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Comorbidity and health services' usage in children with autism spectrum disorder: a nested case-control study

Copyright Cambridge University Press 2020 ;The Author(s) 2020 2020 The Author(s) ;ISSN: 2045-7960 ;EISSN: 2045-7979 ;DOI: 10.1017/S2045796020000050 ;PMID: 31987063

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