Journal article
Autism and Medical Complexity Among Children in the United States
Pediatrics (Evanston), v 155(3), p1
01 Mar 2025
PMID: 39894052
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND AND OBJECTIVES Ongoing systems-level changes aim to better identify and remedy the unmet health care needs of children with medical complexity (CMC). In tandem, home- and community-based services are expanding to support autistic children and their families. Despite the potential for overlap, CMC and autistic children are treated independently in services, research, and policy. We estimated the overlapping prevalence of CMC and autism among US children and health care expenditures for autistic CMC in comparison with other children.METHODS We analyzed 2 national cross-sectional surveys: the National Survey of Children's Health (NSCH; 2017-2018, 2019-2022, and 2021-2022) and the Medical Expenditures Panel Survey (MEPS; combined 2010-2021), selecting for children aged 0 to 17 years. CMC were defined using 2 different algorithms varying in stringency.RESULTS In the most recent 2021 to 2022 NSCH (n = 103 748), the prevalence of CMC among autistic children was 59.28% (95% CI, 55.61%-62.84%) using one algorithm and 17.56% (95% CI, 14.41%-21.24%) using the more stringent algorithm. Forty-one percent of CMC were autistic using either algorithm. In the MEPS data (n = 55 637), autistic CMC had significantly greater median health care expenditures compared with other CMC and other autistic children.CONCLUSIONS There is extensive overlap of CMC and autism among children in the United States. When medical complexity and autism are both evident, expenditures are significantly higher than for either category alone. Despite this overlap and the associated high need, CMC and autism are generally treated as separate groups in services, research, and policy. These findings underscore the importance of cohesively understanding service needs across CMC, autistic children, and their caretakers.
Metrics
Details
- Title
- Autism and Medical Complexity Among Children in the United States
- Creators
- Philip H. Smith - Drexel University, A.J. Drexel Autism InstituteLindsay L. Shea - Drexel University, Health Management and PolicyJessica E. Rast - Drexel University, A.J. Drexel Autism InstituteLauren Hino - Drexel Univ, AJ Drexel Autism Inst, Philadelphia, PA USACorey BriskeyDiana E. Schendel - Drexel University, A.J. Drexel Autism Institute
- Publication Details
- Pediatrics (Evanston), v 155(3), p1
- Publisher
- Amer Acad Pediatrics
- Number of pages
- 9
- Grant note
- UT6MC45902; UT2MC39440 / Health Resources and Services Administration (HRSA) of the US Department of Health and Human Services (HHS) P50HD111142 / Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- A.J. Drexel Autism Institute; Health Management and Policy
- Web of Science ID
- WOS:001565661500019
- Scopus ID
- 2-s2.0-86000360496
- Other Identifier
- 991022024209804721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Public, Environmental & Occupational Health
- Substance Abuse