Healthcare service use patterns among autistic adults: A systematic review with narrative synthesis.
Across the lifespan, autistic individuals use emergency and inpatient care more because routine outpatient care is too hard to reach.
01Research in Context
What this study did
Stofleth et al. (2022) looked at 16 studies about how autistic adults use hospitals. They wanted to see if these adults visit the ER or stay in the hospital more than other adults.
The team pulled papers from many countries. They counted how often autistic adults used emergency rooms, inpatient beds, and regular doctor visits.
What they found
Autistic adults went to the ER or were admitted to the hospital just as often or more than non-autistic adults. The studies showed they do not get enough routine outpatient care.
In plain words: they land in crisis care because basic care is missing.
How this fits with other research
Goris et al. (2021) and Iannuzzi et al. (2022) found the same spike in ER use, but for kids and teens. Together the picture is clear: across all ages, autistic people use emergency services more.
Amaral et al. (2019) zoomed in on privately insured teens. Their psychiatric ER rate was ten times higher than typical peers. This backs up the idea that outpatient mental-health care is too thin.
Sutherland et al. (2002) warned about untreated conditions in adults with developmental disability. Daniel’s 2022 review updates and sharpens that old signal for autistic adults specifically.
Why it matters
If you write care plans or coordinate services, treat ER visits as a red flag for missing outpatient support. Add goals that teach clients how to make doctor appointments, fill scripts, and ask for help before a small issue explodes. Share these papers with medical partners to argue for longer visit times, sensory-friendly clinics, and care navigators.
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02At a glance
03Original abstract
Autistic adults often have complex healthcare needs due to factors like having other health conditions, sensory sensitivities, and limited access to healthcare providers who are trained to provide care for them. All these factors may influence the healthcare services that autistic adults use. In this review, we searched six electronic research databases to gather the most recent evidence about how often autistic adults use five important healthcare services (the emergency department, hospitalization, outpatient mental health, preventive services, and primary care) compared to populations of non-autistic adults. A total of 16 articles were ultimately included in this review. Most articles found that autistic adults had equal or higher use of healthcare services than non-autistic adults. Autistic adults frequently used the emergency department and hospital. This may indicate that routine outpatient care in the community is not meeting their needs. Our findings show the importance of improving care at this level for autistic adults to reduce overuse of the emergency department (in this article referred to as ED) and hospital.
Autism : the international journal of research and practice, 2022 · doi:10.1177/13623613211060906