Brief Report: Service Use and Associated Expenditures Among Adolescents with Autism Spectrum Disorder Transitioning to Adulthood

J Autism Dev Disord. 2018 Sep;48(9):3223-3227. doi: 10.1007/s10803-018-3563-4.


This study compared Medicaid service utilization and expenditures among adolescents with autism spectrum disorder (ASD) to adolescents with intellectual disability (ID) as they aged into adulthood. Medicaid Analytic eXtract (MAX) data was used to identify a national cohort. Winsorization was utilized to control for expenditure outliers. A greater proportion of adolescents with ASD utilized most services. Decreases in the use of key services, including psychiatric outpatient services, were observed for both groups. Changes in medical services, such as increases in inpatient and long term care services, among the ASD cohort suggest medical needs of adolescents with ASD change as they age. Information remains lacking on changing ASD symptom presentation during the transition to adolescence.

Keywords: Autism; Intellectual disability; Medicaid; Service use; Transition.

MeSH terms

  • Adolescent
  • Autism Spectrum Disorder / economics*
  • Autism Spectrum Disorder / epidemiology
  • Autism Spectrum Disorder / psychology*
  • Autism Spectrum Disorder / therapy
  • Child
  • Female
  • Health Expenditures* / trends
  • Humans
  • Intellectual Disability / economics
  • Intellectual Disability / epidemiology
  • Intellectual Disability / psychology
  • Intellectual Disability / therapy
  • Male
  • Medicaid / economics*
  • Medicaid / trends
  • Patient Acceptance of Health Care / psychology*
  • Patient Transfer / economics*
  • Patient Transfer / methods
  • Patient Transfer / trends
  • United States / epidemiology