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. 2017 Jul 18;7(7):e017377.
doi: 10.1136/bmjopen-2017-017377.

Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study

Yona Lunsky  1   2 , Jonathan A Weiss  3 , Melissa Paquette-Smith  4 , Anna Durbin  1   2   5 , Ami Tint  1   3 , Anna M Palucka  1   2 , Elspeth Bradley  2
Affiliations

Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study

Yona Lunsky et al. BMJ Open. .

Abstract

Objectives: To determine predictors of emergency department (ED) visits in a cohort of adolescents and adults with autism spectrum disorder (ASD).

Design: Prospective cohort study.

Setting: Community-based study from Ontario, Canada.

Participants: Parents reported on their adult sons and daughters with ASD living in the community (n=284).

Main outcome measures: ED visits for any reason, ED visits for medical reasons and ED visits for psychiatric reasons over 1 year.

Results: Among individuals with ASD, those with ED visits for any reason were reported to have greater family distress at baseline (p<0.01), a history of visiting the ED during the year prior (p<0.01) and experienced two or more negative life events at baseline (p<0.05) as compared with those who did not visit the ED. Unique predictors of medical versus psychiatric ED visits emerged. Low neighbourhood income (p<0.01) and living in a rural neighbourhood (p<0.05) were associated with medical but not psychiatric ED visits, whereas a history of aggression (p<0.05) as well as being from an immigrant family (p<0.05) predicted psychiatric but not medical emergencies.

Conclusions: A combination of individual and contextual variables may be important for targeting preventative community-based supports for individuals with ASD and their families. In particular, attention should be paid to how caregiver supports, integrative crisis planning and community-based services may assist in preventing or minimising ED use for this vulnerable population.

Keywords: Accident and emergency medicine; Autism spectrum disorder; Hospital.

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Conflict of interest statement

Competing interests: None declared.

References

    1. Deavenport-Saman A, Lu Y, Smith K, et al. . Do children with autism overutilize the emergency department? Examining visit urgency and subsequent hospital admissions. Matern Child Health J 2016;20:306–14.10.1007/s10995-015-1830-y - DOI - PubMed
    1. Iannuzzi DA, Cheng ER, Broder-Fingert S, et al. . Brief report: emergency department utilization by individuals with autism. J Autism Dev Disord 2015;45:1096–102.10.1007/s10803-014-2251-2 - DOI - PubMed
    1. Kalb LG, Stuart EA, Freedman B, et al. . Psychiatric-related emergency department visits among children with an autism spectrum disorder. Pediatr Emerg Care 2012;28:1269–76.10.1097/PEC.0b013e3182767d96 - DOI - PubMed
    1. Liu G, Pearl AM, Kong L, et al. . A profile on emergency department utilization in adolescents and young adults with autism spectrum disorders. J Autism Dev Disord 2017;47:347–58.10.1007/s10803-016-2953-8 - DOI - PubMed
    1. Vohra R, Madhavan S, Sambamoorthi U. Emergency department use among adults with autism spectrum disorders (ASD). J Autism Dev Disord 2016;46:1441–54.10.1007/s10803-015-2692-2 - DOI - PMC - PubMed