Date of Award

8-2021

Degree Name

Doctor of Philosophy

Department

Interdisciplinary Health Sciences

First Advisor

Dr. Rob Lyerla

Second Advisor

Dr. Michelle Suarez

Third Advisor

Dr. Kiera Fogarty

Keywords

Autism, health insurance

Abstract

The prevalence of Autism Spectrum Disorders continues to rise despite barriers of changes to diagnostic criteria and lack of insurance coverage. Increases in prevalence affect costs associated with a disorder since cost of health care services are often estimated based on utilization of services. This can also affect an individual’s ability to access to health care services. To equitably distribute autism services to individuals an accurate estimation of the true prevalence of autism is needed.

Access to health care can be influenced by the type of insurance coverage a person holds. Other factors, such as socio-economic status, ethnicity, location of diagnosis and geographic residence of the patient may influence the ability of individuals ability to access health care services. This is potentially also true for autism.

To examine the national prevalence of autism in relation to the type of insurance a person holds, the region of the country, recent provider visit and SES using a publicly available, data from the National Health Interview Survey was examined. Statistical methods determined change in variable proportions over time and a logistic regression model was used to determine the relationship between the predictor variables (e.g., insurance type, geography, SES, and provider visit) and a diagnosis of autism.

There were statistically significant differences in the change of the predictor variables over time, yet the change in percent of proportion was small. The regression model revealed Medicaid (as compared to Military insurance, private pay and employer-based insurances) was significantly related to a diagnosis of autism.

Medicaid enrollment appears to provide increased access to a wider variety of autism services compared to private insurances, which could affect the ability of an individual receiving an autism diagnosis. However, further exploration of other potential factors were inconclusive, and future studies should consider more the role of specific provider types as well as site of diagnosis (educational vs clinical).

Access Setting

Dissertation-Open Access

Download

Share

COinS