Children with Autism Spectrum Disorders and Utilization of Emergency Department Services

Background:  The high prevalence of Autism Spectrum Disorders (ASD) has significant implications and presents challenges to the health care system.  Increased utilization of emergency department (ED) services adds extra burden to an already overstretched health care safety net. 

Objectives:  To determine the frequency of visits, most common diagnoses, distance traveled, and time of day children with ASD utilized emergency department services.

Methods:  Descriptive analysis of ED administration data from 2006 – 2009.  The setting was an urban, tertiary children’s hospital, with a Level I Trauma Center, and ED visits over 60,000 visits annually.  The patinets were 169,948 children accounting for 246,385 visits; primarily Hispanic from low income households.  The main outcome measure was the number of ED Visits per child, per calendar year, and whether an ED visit resulted in hospital admission.  ED administration data provided patient demographics, principle diagnoses and time of arrival. Numbers of visits per patient, per year was calculated based on unique individual identifiers. ASD related ED visit was defined if the discharge diagnosis included an ASD ICD-9 code. 

Results:  Children with ASD visited the ED 20% more; were older, occurred during weekday hours, and were less likely to result in hospital admission; the top 3 diagnoses made were identical to children without ASD.

Conclusions:  Children with ASD use the ED for typical, routine childhood illnesses during times when most primary care providers are available. Our data suggests further training of primary care providers to recognize the presentation of common illnesses among children with ASD may be needed.