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Community-based service use in preschool children with autism spectrum disorder and associations with insurance status

机译：基于社区的服务在学龄前儿童中使用自闭症谱系障碍和保险状况的关联

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Background: ASD-related services can improve outcomes for children, but less is known about service outside of school settings during preschool age. We aimed to describe amount and category of community-based service use among 3-5-year-old children with ASD and examine differences by health insurance. Methods: We used cross-sectional data on 792 children with ASD diagnoses in the Study to Explore Early Development, a community-based study of neurodevelopment with enrollment between 2012-2016. Mothers reported current child service use and insurance status at study entry. We used log-Poisson and logistic regression to compare service use by insurance group. Results: Nearly 40% of children were not receiving community-based services at study entry. Children with public insurance had fewer total services than children with private or both insurances. After adjustment for sociodemographic confounders, insurance status was not associated with amount of different categories of community-based services. However, children with public insurance alone were least likely to receive community-based behavioral therapy and most likely to receive psychotropic medication compared to other insurances. Conclusion: Many preschool-aged children do not receive community-based services, with receipt of some service types associated with insurance type. Increasing access and availability for evidence-based service, especially for beneficiaries of public insurance, may improve service use and outcomes.
机译：背景：与亚科斯委员会相关的服务可以改善儿童的结果，但在学龄前的年龄期间，在学校环境之外的服务较少。我们的旨在描述3-5岁儿童在有ASD中的基于社区的服务使用量和类别，并通过健康保险检查差异。方法：我们在研究中使用了792名儿童的横断面数据，在研究中探讨了早期发展，是2012 - 2016年间注册的社区基于社区的神经发育研究。母亲报告了当前的儿童服务和保险状态在学习条目。我们使用了Log-Poisson和Logistic回归来比较保险组的服务使用。结果：近40％的儿童在学习条目中没有收到基于社区的服务。公共保险的儿童与私人或两项保险的儿童有比较少的服务。经过调整社会渗目混淆后，保险状况与基于社区服务的不同类别的数量无关。然而，仅有公共保险的儿童最不可能接受基于社区的行为治疗，并且最有可能与其他保险相比接受精神药物。结论：许多学龄前儿童的儿童没有收到基于社区的服务，收到与保险类型相关的一些服务类型。增加基于证据的服务的访问和可用性，特别是对于公共保险的受益者，可能会改善服务使用和结果。

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