OBJECTIVES: Autism is a common developmental disability among children. The study aims to identify the demographic disparities in health care cost and resource utilization in children with Autism.

METHODS: A retrospective study, using Optum’s de-identified Clinformatics Data Mart Database, was carried out among children aged 2-18 years who had ≥2 claims with a diagnosis of autism (identified using ICD-10 Codes) during 1^stJan. 2018- 31^stDec. 2020. Patients were followed for one year to identify their autism-related healthcare costs (medical only) and resource utilization (number of healthcare visits). These metrics were evaluated for disparity by different demographic parameters like age groups, gender, and races. Appropriate statistical tests were applied to look for any significant differences. We further investigated the top 10 procedures that were utilized by children of different races to identify if there was any disparity in the utilization of these procedures which lead to the difference in cost.

RESULTS: A total of 59,436 autistic patients were included in the study. There was a significant disparity in average annual healthcare visits per patient by race, with Caucasians and Asians having the highest average visits (~30) and African Americans having the lowest (~18) average visits. The mean medical cost was significantly higher for children aged <=3 years and 4 to 6 years as compared to higher age groups (P <.0001). Children of Asian origin had significantly higher mean medical costs as compared to Caucasians ($23,147 vs. $10,516; P<.0001); Hispanics ($23,147 vs. $12,033; P<.0001) and African Americans ($23,147 vs. $9,324; P<.0001). Further analysis revealed that children of Asian origin had significantly higher mean medical cost as compared to Caucasians across each age groups. There was no significant disparity in cost and resource utilization by gender.

CONCLUSIONS: There were significant disparities in healthcare cost and resource utilization among autistic children based on race and age.