Healthcare expenditures for autism during times of transition: Disadvantaged families fall behind

Research Objective: Families raising children with autism often experience difficulties accessing services, but there is limited evidence to position these experiences in time as they relate to critical childhood milestones. This study explores the association between school transition and healthcare expenditures to identify when difficulties with access are likely to occur. Study Design: Pooled Medical Expenditure Panel Survey (MEPS) data from 2000 through 2009 provide a national sample of families raising children with autism (n=318). First, a cross section design is used to assess if transition is associated with access to care. Then, two-year panel data are used to assess the association of transition with a change in access. Access is measured with total and family out-of-pocket healthcare expenditures. Transition is a dichotomous measure identifying families with a child in a period of school transition. Ordinary least squares models estimate the association of transition and expenditures, controlling for other predisposing, enabling and need characteristics of the child and family. Interactions with measures of disadvantage (minority, high impairment) assess transition experiences for these families. Findings: Preliminary findings indicate children from minority families or with high impairment experience reduced total healthcare expenditures during times of transition (-$3,700, p<0.05 and -$4,000, p<0.01). Children who are not disadvantaged benefit from increased family out-of-pocket expenditures ($700, p<0.01 and $600, p<0.05) during times of transition. Implications: Knowing when disadvantaged children with autism are most at risk can inform policies to support better continuity of care for these children.