Barriers to Care: An Investigation of Autism, Insurance, and Service Utilization

Background: Past research shows that the amount of covered services an individual with autism spectrum disorder (ASD) receives can vary based on health insurance type (Wang et al., 2013). Coverage of care differs based on health insurance type and may encourage or deter people from seeking care. Therefore, it is necessary to study the impact of different health insurance types on services use among individuals with ASD. Barriers to care for individuals with ASD are especially pertinent to study because their quality of life can be increased through access to certain health services. By studying the impact of having public insurance, private insurance, or a combination of both on service utilization for individuals with ASD, recommendations for ameliorating barriers to care can be generated.

Objectives: This purpose of this study is to investigate how the service utilization of individuals with ASD is impacted based on their health insurance type. This research aims to predict the health insurance type driven barriers that individuals with ASD face in accessing the services needed to lead maximally independent lives.

Methods: The data for this research is from the 2009 Pennsylvania Autism Needs Assessment which contains survey results for 3,500+ individuals with ASD and their caregivers. This data contains variables that identify individuals’ health insurance type and the services that they have accessed. Comparable proportions were used to obtain a “snapshot” of current service utilization. Linear regression models controlling for multiple factors including but not limited to race, ethnicity, income education status and sex, were designed to predict service utilization. The results from these regression models are forthcoming.

Results: Preliminary results show that depending on the service, it is variably advantageous to have public insurance, private insurance, or both. For neurology services, there was a greater percent utilization for individuals with private insurance (25.6%) compared to individuals with public insurance (19.0%). However, for services for sleep problems, individuals with public insurance had a greater percent utilization (25.7%) than individuals with private insurance (15.2%).  Further research will be conducted to determine if any trends regarding service utilization are present.

Conclusions: Completed results of this study will be used to identify any barriers that exist for individuals with ASD in accessing services based on insurance type.  Results will be used to craft policy recommendations to benefit individuals with ASD and their families and offer ways to increase access to services regardless of insurance status.

Wang, L. & Leslie, D.L. (2010). Health care expenditures for children with autism spectrum

disorders in Medicaid. Journal of the American academy of child and adolescent psychiatry, 49 (11), 1165.