Volume 101, March 2026, Pages 7-9Author links open overlay panel, AbstractBackground

Sensory reactivity and communication challenges can complicate navigating the healthcare system and managing health concerns for autistic individuals.

Methods

Emergency department (ED) encounters for autistic and non-autistic patients from 2023 within 14 hospitals of a large NY healthcare system were evaluated using ICD-10 code F84.0. Outcomes included: percentage of patients accessing care, top primary diagnoses, ED utilization across various ages, admission status, and duration of hospitalization.

Results

The study included 711,254 ED visits from 523,057 patients. 1228 patients were documented autistic (0.23 %), which was statistically significantly less than the expected autistic population proportion (p < 0.0001). We found a significant association between age group and autism diagnosis (p < 0.0001), with there being higher proportions of autistic patients in younger age groups. 12.3 % of encounters with autistic patients resulted in admission to the hospital, compared to 23.3 % of the patients without this documented diagnosis (p < 0.0001). The median length of hospitalization for patients with documented autism was shorter (4 days (IQR 2–7)) and 3 days ((IQR 1–6)) (p < 0.0001) for non-autistic and autistic patients, respectively).

Conclusions

In this study, autistic patients utilized the ED at a lower rate than would be expected given the prevalence of autism. The majority of autistic patients seen in the ED were younger (<30 years old). The primary diagnosis varied between autistic and non-autistic patients. Further study is needed to better characterize the challenges seeking care throughout healthcare settings and ensure adequate healthcare supports for the autistic community.

Section snippetsBackground

In the United States, the most recent data indicates that 1 in 31 children is diagnosed with autism by the age of 8 years and 1 in 44 adults is autistic. The prevalence of autism, currently 3.2 % in children and 2.3 % in adults in the US, has increased over time [1,2]. The prevalence of autism does vary between states and is not as well documented or as current in all areas. Using public and non-public school district data of children 3–21 years of age receiving special education services in

Methods

ED encounters for autistic and non-autistic patients from the year 2023 within a large NY healthcare system were evaluated using the ICD-10 code F84.0. Fourteen hospital locations within the Northwell Health system in New York were included (Cohen Children's Medical Center, Glen Cove hospital, Huntington hospital, LIJ Forest Hills hospital, LIJ Valley Stream hospital, Lenox Health Greenwich hospital, Lenox Hill hospital, Long Island Jewish hospital, North Shore University hospital, Plainview

Results

The study included 711,254 ED visits during the year 2023 from 523,057 distinct patients. Of the included patients, 1228 were documented as autistic (0.23 %) in the medical record, which was statistically significantly less than the expected autistic population proportion (p < 0.0001). There were 104,893 distinct patients in the 0–19 age range, and 796 of them (0.76 %) were diagnosed with autism, which was significantly different from available autism prevalence data for children (p < 0.0001).

Discussion

The healthcare system can be difficult for any patient to navigate. Limited time available by providers, the uncertainty and fear associated with illness and the unknown, as well as a lack of resources in the healthcare system, all contribute to the struggles of healthcare encounters. Patients utilizing healthcare services have expressed disappointment with services when providers do not attend to their priorities or dismiss their concerns. Satisfaction is linked with prior satisfaction with

CRediT authorship contribution statement

Eleny Romanos-Sirakis: Writing – review & editing, Writing – original draft, Resources, Project administration, Methodology, Investigation, Formal analysis, Data curation, Conceptualization. Jon Javor: Writing – review & editing, Validation, Formal analysis, Data curation.

Declaration of competing interest

The authors have no conflicts of interest. No funding was received for this study. ERS conceptualized the study, developed the methodology, reviewed the data and wrote the manuscript. JJ completed the statistical analysis and contributed to the methods section of the manuscript. Both authors have edited and approved the final manuscript.

The authors have no conflicts of interest. The study was deemed exempt from full evaluation of the Institutional Review Board.

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