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Tuesday, April 15, 2014

Hospitalization

In the Journal of Autism and Developmental Disorders, Aaron Nayfack and colleagues have an article titled "Hospitalizations of Children with Autism Increased from 1999 to 2009."

The abstract:
We performed a retrospective analysis of hospital discharges for children with autism, in comparison to children with cerebral palsy, Down syndrome, mental retardation/intellectual disability, and the general population. Hospitalizations for autism increased nearly threefold over 10 years, especially at the oldest ages, while hospitalizations for the other groups did not change. Leading discharge diagnoses for each age group in children with autism included mental health and nervous system disorders. Older age, Caucasian ethnicity, and living in a region with a high number of pediatric beds predicted hospitalizations associated with mental health diagnoses. These findings underscore the need for comprehensive clinical services that address the complex needs of children with autism to prevent costly hospitalizations.
From the discussion section:
This current study reported factors that placed an individual with autism at increased risk for hospitalization, but does not explain why these hospitalizations increased during the study period. One possibility is the rising prevalence of autism has been met by a decline in financial support for outpatient and community resources. In this scenario, overwhelmed parents, schools, and community providers of mental health resources may have been unable to meet the needs of these patients and this failure to treat adequately in the outpatient sector may have led to a direct increase in hospitalizations. A recent study by Mandell et al. (2012) adds evidence to support this argument. They found that the enhanced provision of respite care to caregivers
of children with autism led directly to a decrease in hospitalization.
 Mandell, D. S., Xie, M., Morales, K. H., Lawler, L., McCarthy, M., & Marcus, S. C. (2012). The interplay of outpatient services and psychiatric hospitalization among medicaid-enrolled children with autism spectrum disorders. Archives of Pediatric and Adolscent Medicine, 166(1), 68–73.