Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #107908

Walter J. Jones, PhD¹, Clara E. Dismuke, PhD¹, Jane Charles, MD², and Desmond Kelly, MD³. (1) Department of Health Administration and Policy, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, 843-792-8464, jonesw@musc.edu, (2) Division of Genetics and Developmental Pediatrics, Medical University of South Carolina, 171 Ashley Avenue, Charleston, SC 29425, (3) Division of Developmental-Behavioral Pediatrics, Greenville Hospital System Children's Hospital, 701 Grove Road, Greenville, SC 29605

The numbers of autistic children, and their care costs, have been steadily increasing in the U.S. Twenty states have expanded Medicaid eligibility for autistic children with Katie Beckett-TEFRA, but other states are waiting for more cost information. The authors are currently researching the medical utilization and costs of children with autism in a TEFRA state, South Carolina. The first research stage entailed an analysis of year 2001 Medicaid expenditures for all autistic children (N=1602) in the following categories: inpatient, emergency department, other outpatient, primary care, specialty care, clinic care, speech and hearing, mental health, pharmaceutical, and total. The highest costs were found in mental health and clinic care, non-TEFRA children were more likely to incur higher inpatient and emergency department charges, and there also were some racial differences, with non-white children experiencing higher emergency department charges, and white children having higher average outpatient, pharmacy and speech/hearing charges. The second stage of the research focused on catchment areas for two state autism specialty clinics, with a smaller client sample (N=733). This analysis found a significant racial difference in total Medicaid expenditures, with white children having higher average levels. Finally, non-TEFRA children also had higher average overall expenditures. The initial results, including the first intensive analysis of autism specialty clinic care, shows that both TEFRA and specialty clinic expansion may be cost-effective methods of enhancing access to autism care. Current autism care patterns may also result in racially disparate levels of care – a possibility warranting further investigation.

Learning Objectives: At the conclusion of this session, the participant will be able to

• Recognize the importance of TEFRA and specialty clinics in enhancing access to care for autistic children
• Identify the various ways in which TEFRA and specialty clinic access affect Medicaid service use and expenditures
• Analyze the possibility that TEFRA and specialty clinic access lead to racially disparate levels of care under current program structures and processes

Keywords: Access to Health Care, Medicare/Medicaid

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.