The Society for Social Work and Research

2014 Annual Conference

January 15-19, 2014 I Grand Hyatt San Antonio I San Antonio, TX

Autism Spectrum Disorders and Families' Financial Burden: The Association With Health Insurance Coverage

Friday, January 17, 2014: 10:00 AM
HBG Convention Center, Room 002A River Level (San Antonio, TX)
* noted as presenting author
Susan L. Parish, PhD, MSW, Nancy Lurie Marks Professor of Disability Policy and Director, Lurie Institute for Disability Policy, Brandeis University, Waltham, MA
Kathleen C. Thomas, PhD, Research Associate, University of North Carolina at Chapel Hill, Chapel Hill, NC
Christianna Williams, PhD, Research Associate, University of North Carolina at Chapel Hill, Chapel Hill, NC
Morgan Crossman, Doctoral Student, Brandeis University, Waltham, MA
Background & Purpose: We examined the relationship between family financial burden and children’s health insurance coverage in US families raising children with autism. The growing prevalence of autism has worrisome public health implications; the Centers for Disease Control & Prevention estimates that 1 in 88 children have an autism spectrum disorder. Families often incur catastrophically high health costs for their children with autism.

Methods: We used pooled data from the 2000-2009 panels of the US-based Medical Expenditure Panel Survey to examine out-of-pocket spending incurred by families caring for children with autism (n=316). The survey is nationally-representative of US families. Measures of family financial burden included any out-of-pocket spending in the previous year, and spending as a percentage of families’ income. Logistic and OLS regression models estimated families’ likelihood of having any out-of-pocket spending for the health care of their child with autism and relative financial burden among families that incurred any out-of-pocket spending, respectively.

Results: 82% of US families incurred any out-of-pocket spending for the health care costs of their child with autism in the past year. Families spent an average of 4.1% of income per capita on their child’s health care. After controlling covariates including severity of the condition and other family and child characteristics, families raising children with private health insurance were more than five times as likely to have any out-of-pocket spending compared to children with public health insurance. The most common expenditure types were medications, outpatient services, and dental care.

Conclusions & Implications: Families of privately-insured children with autism spectrum disorders incur significantly greater out-of-pocket spending for their children’s health care. This study provides additional evidence of the relative inadequacy of private health insurance coverage in meeting the needs of US children with autism spectrum disorders. Improving private insurance coverage, particularly in medications, outpatient services and dental care, would reach a large proportion of families raising children with autism and reduce their financial burden.