Health Service Use and Health Seeking Behaviours of Australian Adults on the Autism Spectrum

Background:  Adults on the autism spectrum have unique health needs and frequently experience barriers to accessing healthcare related to emotional regulation, sensory sensitivity and healthcare system navigation. Many adults on the spectrum report low satisfaction with patient-provider communication and high levels of unmet healthcare needs. Difficulties with accessing healthcare may contribute to adults on the spectrum often exhibiting poorer physical and mental health outcomes in comparison to the general adult population.

Objectives:  To describe the health service use and health seeking behaviours of Australian adults on the autism spectrum.

Methods:  The Australian Longitudinal Study of Adults with Autism is a questionnaire-based study which aims to describe the physical and mental health, productivity, wellbeing and health service use of autistic adults in Australia aged 25 years and older. Rolling recruitment has occurred since July 2015. Participants are screened for inclusion and either emailed a link to the online version or mailed a paper copy of the questionnaire. Descriptive statistics and chi square analysis were performed. Further analysis will be conducted to account for demographic differences between groups.

Results:

Questionnaires were completed by 184 autistic adults and 129 non-autistic adults. Autistic participants were aged 25-80 years (mean 42.6 SD12.2) and non-autistic participants 25-79 years (mean 43.6 SD13.6). Over half (56.8%) of autistic respondents were female, 38.3% were male and 4.9% identified their gender as 'other'. The majority of non-autistic respondents (79.0%) were female.

The average length of visit to the general practitioner (GP) did not differ between autistic and non-autistic participants with the most commonly reported length of GP visit being 5-10 minutes (30%, 32%, respectively) and 10-15 minutes (33%, 35%, respectively). There were no differences in satisfaction with GP services between participant groups (p<0. 248) with more than 70% of both groups reporting they were satisfied or very satisfied. However when asked about the amount of help received from the GP, a larger proportion of autistic participants reported receiving ‘a little’ (21%) or ‘none at all’ (6%) in comparison to non-autistic participants (12%, 2% respectively) (p=0.033).

Autistic and non-autistic participants had different motivations to attend an appointment with a health professional (p<0.001). The majority (72%) of non-autistic participants attended a health professional because they wanted to go; compared to 57% of autistic participants. Twenty percent of autistic participants attended for both wanting to go themselves and being persuaded to go by someone else. Just over a third of autistic participants reported having delayed seeing a health professional for at least four weeks in comparison with only 15% of non-autistic participants. The reasons autistic participants delayed seeing a health professional included financial restraints, being unable to get an appointment and anxiety.

Conclusions: Generally, autistic and non-autistic adults reported similar lengths of GP visits and were satisfied with GP services in Australia. Less autistic adults attend a health professional because they want to and more autistic adults delay seeing a health professional due to a variety of reasons including anxiety. This study has important implications for the healthcare system in Australia.