Article Text
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.
- Autism spectrum disorder
- Accident and emergency medicine
- Hospital
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Footnotes
Contributors YL, JAW, AMP and EB were the primary creators of the concept and design of this study. The analytic approach was created by YL and JAW and carried out by MP-S, AD and AT. YL, MP-S, AD and AT were responsible for drafting the manuscript and integrating all coauthor input. All coauthors contributed substantively to the interpretation of the results and to draft revisions and have approved the final version of the manuscript.
Funding This research was funded by the Canadian Institutes of Health Research (MOP 102677). JAW is supported by the Chair in ASD Treatment and Care Research (Canadian Institutes of Health Research RN162466-284208 in partnership with NeuroDevNet, Sinneave Family Foundation, CASDA, Autism Speaks Canada and Health Canada).
Competing interests None declared.
Ethics approval Centre for Addiction and Mental Health; York University.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement No additional data are available.