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

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 w...

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Autores principales: Lunsky, Yona, Weiss, Jonathan A, Paquette-Smith, Melissa, Durbin, Anna, Tint, Ami, Palucka, Anna M, Bradley, Elspeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541491/
https://www.ncbi.nlm.nih.gov/pubmed/28720619
http://dx.doi.org/10.1136/bmjopen-2017-017377
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author Lunsky, Yona
Weiss, Jonathan A
Paquette-Smith, Melissa
Durbin, Anna
Tint, Ami
Palucka, Anna M
Bradley, Elspeth
author_facet Lunsky, Yona
Weiss, Jonathan A
Paquette-Smith, Melissa
Durbin, Anna
Tint, Ami
Palucka, Anna M
Bradley, Elspeth
author_sort Lunsky, Yona
collection PubMed
description 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.
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spelling pubmed-55414912017-08-18 Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study Lunsky, Yona Weiss, Jonathan A Paquette-Smith, Melissa Durbin, Anna Tint, Ami Palucka, Anna M Bradley, Elspeth BMJ Open Health Services Research 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. BMJ Publishing Group 2017-07-18 /pmc/articles/PMC5541491/ /pubmed/28720619 http://dx.doi.org/10.1136/bmjopen-2017-017377 Text en © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Health Services Research
Lunsky, Yona
Weiss, Jonathan A
Paquette-Smith, Melissa
Durbin, Anna
Tint, Ami
Palucka, Anna M
Bradley, Elspeth
Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study
title Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study
title_full Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study
title_fullStr Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study
title_full_unstemmed Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study
title_short Predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study
title_sort predictors of emergency department use by adolescents and adults with autism spectrum disorder: a prospective cohort study
topic Health Services Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5541491/
https://www.ncbi.nlm.nih.gov/pubmed/28720619
http://dx.doi.org/10.1136/bmjopen-2017-017377
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