Telemedicine Use Amongst US Children and Young Adults With Autism: Utilization, Costs and Common Conditions.

BACKGROUND: The management of autism and other comorbidities among children and young adults places a substantial economic and logistical burden on families. Telemedicine offers potential benefits for children and young adults with autism by improving access to care, reducing costs, and supporting families in managing ongoing treatment needs, all highlighted during the COVID-19 pandemic. While telemedicine has shown positive benefits in neurotypical pediatric populations, limited evidence supports and describes the use of telemedicine for children with autism. OBJECTIVE: This study examined children and young adults with autism and assessed the association between telemedicine services and annual combined out-of-pocket (OOP) medical costs among children and young adults with autism. DESIGN: Cross-sectional data from the U.S. nationally representative Medical Expenditure Panel Survey (MEPS) were analyzed. Independent variables included demographics, medical conditions, utilization patterns, and healthcare expenditures. A weighted log-linear regression model estimated combined medical OOP costs, and a binary weighted logistic regression examined factors associated with telemedicine use. DATA: The study cohort included 189 children and young adults with autism aged 1-21 years from 2020 to 2023. RESULTS: Among them, 62 (32.8%) used telemedicine. By 2023, telemedicine utilization among children and young adults with exceeded those who did not use telemedicine. Telemedicine utilization did not have a significant effect on OOP costs (EXP(β) = 1.30, p = 0.17). Insurance type showed a strong effect, with individuals without Medicaid having much higher odds of incurring OOP costs than those with Medicaid (EXP(β) = 15.91, p < 0.001). Black or African American children had significantly lower odds of telemedicine use compared to non-Hispanic White children (Exp(β) = 0.17, p < 0.05). CONCLUSION: Telemedicine use was not significantly associated with combined OOP medical costs among children and young adults with autism. However, differences were observed in telemedicine use and OOP costs.