WIP 92 - Using Socioecological Factors to Assess Autism Service Disparities among Medicaid-Enrolled Patients: A Rapid Evidence Review

Publication Number: WIP 92.7621

Veronica I. Underwood Carrasco, Oregon Health & Science University, Portland, OR, United States; Sarah Mensah. Asantewaa, Northern Arizona University, Flagstaff, AZ, United States; Katharine E. Zuckerman, Oregon Health & Science University School of Medicine, Portland, OR, United States; Olivia Lindly, Northern Arizona University, Flagstaff, AZ, United States

Background: Disparities remain in access to quality autism services, with persistent variation by interpersonal-, intrapersonal-, community-, structural-, and policy-level factors. An important population to consider when assessing autism service disparities is Medicaid-enrolled patients since 50% of children with autism diagnoses are enrolled in Medicaid, and due to autism diagnosis-based Medicaid eligibility criteria. Therefore, studies using Medicaid claims data to examine autism service disparities may provide unique insights into the demographics being studied and the factors influencing service equity.

Objective: Conduct a rapid evidence literature review grounded in a socioecological framework to identify the individual and intersectional patient demographics, as well as structural (e.g., neighborhood, policy) factors analyzed in studies to describe patterns and disparities.

Design/Methods: In January 2024, we began a rapid evidence literature review with the focused research question “How have Medicaid claims data been used to study disparities or variation in autism services?”. Our interdisciplinary team followed an a-priori systematic protocol in alignment with the Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines. A search strategy was co-developed with health services research librarians and applied to databases (i.e., ERIC, SCOPUS, PubMed, CINAHL Plus, and PsycINFO, which elicited 1,090 total references. The references were imported into Covidence’s systematic review management software where the list was deduplicated, then, individual articles were screened at the title-abstract and full-text levels based on inclusion criteria (i.e., conducted in the US, include an autistic population, use Medicaid claims, empirical/original research, peer-reviewed). Data extraction is currently underway for the 61 included studies, with factors associated with autism service disparities being mapped to levels within the socioecological framework.