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Saturday, May 17, 2008
Champagne Terrace/Bordeaux (Novotel London West)
11:30 AM
Background: Little is known about substance abuse (SA) among people with diagnoses of autism – a population that has experienced increasing levels of community inclusion over the past forty years – a freedom which has facilitated access to alcohol and drugs and the potential for developing SA disorders.
Objectives: Given documented barriers to accessing SA treatment among many populations with disabilities, this study expands knowledge of SA treatment utilization patterns among people with autism.
Methods: This study utilizes standardized performance measures designed by a team of clinicians and health services researchers to measure SA treatment utilization (operationalized as treatment initiation and engagement). Utilization rates are examined retrospectively for people with and without diagnoses of autism (operationalized through the use of the ICD-9-CM diagnostic code 299, childhood psychosis disorder) among the population of low-income people with Medicaid coverage in the United States in 1999. Beneficiaries with autism (N=664) are compared with a random sample of their counterparts without autism (N=700) in logistic regression modeling guided by Ronald Andersen’s sociobehavioral model of healthcare utilization. This model assesses the impact of autism on SA treatment utilization while controlling for predisposing characteristics, enabling resources and need factors.
Results: 25.8 percent of people with autism initiated SA treatment while only 45.2 percent engaged in SA treatment. Multivariate logistic regression modeling suggests that while people with autism were equally likely to access SA treatment as compared to people without autism, they were less likely to engage in SA treatment (adjusted odds ratio=0.53***). People with autism and co-occurring diagnoses of schizophrenia were less likely to initiate SA treatment than were their counterparts (OR=0.51**).
Conclusions: Clinical practice implications relate to needed improvements in behavioral health care for people with autism through cross-system collaboration and the use of integrated treatment approaches.
Objectives: Given documented barriers to accessing SA treatment among many populations with disabilities, this study expands knowledge of SA treatment utilization patterns among people with autism.
Methods: This study utilizes standardized performance measures designed by a team of clinicians and health services researchers to measure SA treatment utilization (operationalized as treatment initiation and engagement). Utilization rates are examined retrospectively for people with and without diagnoses of autism (operationalized through the use of the ICD-9-CM diagnostic code 299, childhood psychosis disorder) among the population of low-income people with Medicaid coverage in the United States in 1999. Beneficiaries with autism (N=664) are compared with a random sample of their counterparts without autism (N=700) in logistic regression modeling guided by Ronald Andersen’s sociobehavioral model of healthcare utilization. This model assesses the impact of autism on SA treatment utilization while controlling for predisposing characteristics, enabling resources and need factors.
Results: 25.8 percent of people with autism initiated SA treatment while only 45.2 percent engaged in SA treatment. Multivariate logistic regression modeling suggests that while people with autism were equally likely to access SA treatment as compared to people without autism, they were less likely to engage in SA treatment (adjusted odds ratio=0.53***). People with autism and co-occurring diagnoses of schizophrenia were less likely to initiate SA treatment than were their counterparts (OR=0.51**).
Conclusions: Clinical practice implications relate to needed improvements in behavioral health care for people with autism through cross-system collaboration and the use of integrated treatment approaches.