School-Based Behavioral Health Service Use and Expenditures for Children With Autism and Children With Other Disorders.

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TitleSchool-Based Behavioral Health Service Use and Expenditures for Children With Autism and Children With Other Disorders.
Publication TypeJournal Article
Year of Publication2016
AuthorsKang-Yi, CD, Locke, J, Marcus, SC, Hadley, TR, Mandell, DS
JournalPsychiatr Serv
Date Published2016 Jan
KeywordsAdolescent, Attention Deficit Disorder with Hyperactivity, Autism Spectrum Disorder, Child, Child, Preschool, Conduct Disorder, Female, Health Expenditures, Humans, Logistic Models, Male, Medicaid, Patient Protection and Affordable Care Act, Pennsylvania, School Health Services, Schools, United States

OBJECTIVE: This study compared use of and associated expenditures for Medicaid-reimbursed school-based and out-of-school services for children with autism spectrum disorder (ASD) and those with other psychiatric disorders.METHODS: Philadelphia County Medicaid claims were used to identify children ages five to 17 who received behavioral health services through Medicaid any time between October 2008 and September 2009 (N=24,271). Children were categorized into four diagnostic groups: autism spectrum disorder (ASD), conduct disorder or oppositional defiant disorder (conduct-ODD), attention-deficit hyperactivity disorder (ADHD), and other psychiatric disorders. Logistic regression analysis compared use of in-school and out-of-school behavioral health services between children with ASD and children with other psychiatric disorders. Generalized linear models with gamma distribution were used to estimate differences in Medicaid expenditures for in-school and out-of-school services and total Medicaid expenditures for both service types by disorder, with adjustments for age, sex, and race-ethnicity.RESULTS: The most common diagnosis was ADHD (40%); 35% had other psychiatric disorders, 21% had conduct-ODD, and 4% had ASD. A significantly greater proportion of children with ASD (52%) received in-school behavioral health services (conduct-ODD, 5%; ADHD, 8%; and other psychiatric disorders, 1.7%) Per-child expenditures for both school-based and out-of-school behavioral health services were significantly higher for children with ASD than for children in the other groups.CONCLUSIONS: Medicaid represents an important source of in-school and out-of-school care for children with ASD and their families. States that expand Medicaid under the Affordable Care Act should give careful consideration to covering school-based mental health services for children with ASD.

Alternate JournalPsychiatr Serv
PubMed ID26278232
PubMed Central IDPMC4701615
Grant ListK01 MH100199 / MH / NIMH NIH HHS / United States
U54 HD086984 / HD / NICHD NIH HHS / United States
K01MH100199 / MH / NIMH NIH HHS / United States
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