17/03/2024
Šta nas je motivisalo da pokrenemo HeAlth projekat?
Nedavne studije pokazuju da ljudi sa autizmom koriste usluge urgentne medicine češće, jer manje koriste preventivne zdravstvene usluge. Sistem zdravstvene zaštite često je nefleksibilan da odgovori na specifičnosti u lečenju pacijenata sa autizmom, iako se pacijenti javljaju zbog lečenja somatskih bolesti i stanja, koje su zajednički svim ljudima, a ne zbog nečega usko povezanog sa autizmom. Postoje slučajevi kada su lekari opšte prakse ili specijalisti odbili da pregledaju pacijenta sa autizmom samo zato što ne znaju dovoljno o karakteristikama ovog stanja, iako je pacijent sa autizmom upućen lekaru sa potrebom za npr. EKG-om.
Pored toga, medicinski komorbiditeti su češći kod ljudi sa autizmom nego u opštoj populaciji. Komorbiditet je prisustvo jedne ili više pridruženih bolesti ili poremećaja koji se podudaraju sa primarnim poremećajem. Na primer, pacijenti sa autizmom imaju 1.6 p**a veću verovatnoću da imaju ekcem ili kožne alergije, 1,8 p**a je verovatnije da će imati astmu i alergiju na hranu, 2.1 p**a je verovatnije da će imati česte infekcije uha. Dalje, 2.2 p**a je verovatnije da će imati teške glavobolje, 3,5 p**a je verovatnije da će imati dijareju ili kolitis i 7 p**a je verovatnije da će imati gastrointestinalne probleme.
Sve ovo ukazuje na neophodnost obuke zdravstvenih radnika da rade sa pacijentima sa autizmom kako bi mogli da koriste redovne zdravstvene usluge u okviru sistema primarne zdravstvene zaštite. To će rezultirati efikasnošću zdravstvenog sistema, nižim troškovima lečenja, ali i smanjenjem anksioznosti kod zdravstvenih radnika i pacijenata sa autizmom u situacijama koje zahtevaju lečenje.
What motivated us to start HeAlth project?
Recent studies show that people with ASD use emergency department (ED) services more often, because they use less preventive health care services. The health care system is often inflexible to respond to the specifics in the treatment of patients with ASD, although patients present for treatment for somatic diseases and conditions, common to all people, and not something closely related to ASD. There are cases when general practitioners or specialist doctors have refused to admit a patient with ASD simply because they do not know enough about the characteristics of this condition, even though the patient with ASD was referred to a doctor with the need for e.g. ECG.
The study by Iannuzzi, D., Hall, M., Oreskovic, N. M., Aryee, E., Broder-Fingert, S., Perrin, J. M., & Kuhlthau, K. A. (2022). Emergency department utilization of adolescents and young adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 1-6. examined emergency department (ED) utilization by adolescents and young adults, 12–30 years of age (AYA) with ASD using the 2016 Healthcare Cost and Utilization Project/National Emergency Department Sample (HCUP/NEDS). They investigated the principal reason for an ED visit, presence of an ambulatory care sensitive condition (ACSC), and likelihood of hospital admission following ED encounter in ASD and Non-ASD cohorts. The ASD cohort had a higher proportion of ED visits for ACSC diagnoses as compared to the Non-ASD cohort. In addition, the likelihood of admission following an ED visit in the ASD cohort was 3.7 times greater than in the Non-ASD cohort.
Another study by Cohen-Silver, J. H., Muskat, B., & Ratnapalan, S. (2014). Autism in the emergency department. Clinical Pediatrics, 53(12), 1134-1138. found that youth (aged 0-17 years) with ASD were up to 30 times more likely to present to the ED than youth without ASD. Individuals with ASD who visited the ED were older, more likely to have public insurance, and more likely to have nonurgent ED visits.
Furthermore, medical comorbidities are more common in people with ASD than in general population. Comorbidity is the presence of one or more additional diseases or disorders that coincide with a primary disorder. For example, patients with ASD are 1.6 times more likely to have eczema or skin allergies, 1.8 times more likely to have asthma and food allergy, 2.1 times more likely to have frequent ear infections. 2.2 times more likely to have severe headaches, 3.5 times more likely to have diarrhoea or colitis, and 7 times more likely to report gastrointestinal problems.
This points to the necessity of training health professionals to work with patients with ASD so that they are able to use regular health services within the primary health care system. This will result in the efficiency of the health system, lower costs of treatment, but also a reduction of anxiety in both health workers and patients with ASD, in situations that require treatment.
