Specialized CAST clinic helps adults with autism receive more preventive services

Research led by The Ohio State University Wexner Medical Center and College of Medicine's School of Health and Rehabilitation Sciences found that adults with autism who received care through Ohio State's Center for Autism Services and Transition (CAST) were significantly more likely to receive preventive care services than national samples of adults with autism.

Study findings are published online in the Journal of General Internal Medicine.

In this retrospective study of administrative (billing) data, researchers compared the receipt of preventive services by patients at CAST—a patient-centered medical home at Ohio State Wexner Medical

Center specifically designed for autistic adults—to national samples of adults with autism who have private insurance or Medicare in the United States.

CAST is the only place in central Ohio—and one of only a few in the nation—where patients can access primary care physicians with the experience to provide comprehensive care for adults with autism and to treat their related, often complex, health care needs.

Adults with autism often face barriers to accessing and using such services for a variety of reasons. Patients with autism may struggle to describe their symptoms, and the lack of health care providers who are knowledgeable about autism reduces accessibility for this population.

In addition, loud, crowded or bright facilities can also can serve as barriers for those who are sensitive to this sensory overload.

"Our study shows how this model of primary care delivery is linked with increased preventive service utilization among adults with autism," said lead author Brittany N. Hand, an assistant professor in Ohio State's School of Health and Rehabilitation Sciences. "Preventive care is especially important for this population because they're at higher risk than the general population for many mental and physical health conditions that can be detected, prevented or managed with routine care."

The study compared 490 CAST patients matched by demographic characteristics to 980 Medicare patients and 980 privately insured patients. The median age of subjects was 21 years old, 79% were male and the median duration of observation was 2.2 years. All CAST patients were residents of Ohio.

"We found that CAST patients had significantly greater odds of receiving any preventive service than Medicare enrolled and privately insured adults with autism," Hand said. "CAST patients were also significantly more likely to receive screenings and vaccinations than either Medicare beneficiaries or privately insured patients."

The preventive services were classified into five categories: general health and wellness; screenings, counseling and therapies; vaccinations and sexual and reproductive health.

"As the population of adults with autism grows, there's an urgent need to address the disparity in the receipt of preventive services by developing and testing evidence-based models of health care delivery that may better meet this population's needs. We plan to do more studies to assess the impact of primary care-based initiatives to improve care and healthcare outcomes for adults with autism," said senior author Jennifer H. Garvin, director of Ohio State's Division of Health Information Management and Systems in the School of Health and Rehabilitation Sciences.