Date Presented 04/22/2023

Therapeutic service utilization decreased by age and measurement year for the Florida autistic population. Provider referrals and policy changes may sustain access beyond childhood for autistic adults.

Primary Author and Speaker: Amber M. Angell

Contributing Authors: Susmita Datta, Guangjin Luo, Camille Parchment, Erica Shoemaker, Timothy Reistetter

PURPOSE: The purpose of this study was to establish contemporary patterns of therapeutic service utilization (occupational and physical therapy) among the Florida autistic population. Therapeutic services may support community participation of autistic individuals, but access to these services appears to decrease with age. There is a lack, however, of recent research investigating these trends.

DESIGN: This retrospective observational study is a secondary data analysis of healthcare claims data using the OneFlorida Data Trust. We hypothesized that among autistic individuals, therapeutic service utilization decreases with age.

METHOD: For the OneFlorida population aged 3-64 with an autism spectrum disorder diagnosis, we included utilization for N=92,253 patients with any therapeutic encounter in the measurement period (2012-2020). We defined therapeutic utilization as the number of ambulatory visits with a primary provider specialty code for occupational or physical therapy. We treated age at first encounter and year as independent variables, and number of utilizations as dependent variables. Controlling for covariates (sex, urbanicity, race, and ethnicity), we conducted a mixed-effect Poisson model.

RESULTS: Holding all other explanatory variables fixed, therapeutic service utilization decreased with age and year (p<0.0001). Physical therapy was less frequently utilized than occupational therapy (p<0.0001). Overall therapeutic utilization was less in males vs. females (p<0.0001) and greater in urban vs. rural areas (p<0.0001). Utilization was less for patients identified as non-Hispanic/non-Latinx (p<0.0001).

CONCLUSION: Therapeutic service utilization decreased with age and measurement year for the Florida autistic population. Changes in clinical practice and healthcare policy may explain changes over time.

IMPACT STATEMENT: Provider referrals and autism insurance mandates may help to sustain therapeutic service utilization beyond childhood for autistic individuals.


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