Date of Award

3-20-2026

Embargo Period

3-26-2026

Document Type

Dissertation

Degree Name

Doctor of Health Administration

Department

Health Administration

College

College of Health Professions

First Advisor

Caitlin Koob

Second Advisor

Daniel L. Brinton

Third Advisor

Timothy Putnam

Abstract

Nationwide, one in 31 children are diagnosed with Autism Spectrum Disorder (ASD), a neurodevelopmental condition associated with substantial healthcare utilization, family burden, and rising system-level costs. Evidence-based interventions such as Applied Behavior Analysis (ABA) have demonstrated improved developmental and behavioral outcomes; however, their relationship to hospitalizations outcomes remain underexamined nationwide. This study employs a retrospective secondary analysis of the 2023 Merative MarketScan Commercial database to examine hospitalization patterns among privately insured children and youth aged 0–21 years diagnosed with ASD. The study aims to 1) describe ASD-related hospitalizations and length of stay, 2) evaluate whether ABA therapy exposure is associated with hospitalizations, and 3) assess geographic differences in hospitalization outcomes. Descriptive statistics were used to examine the sample population, and multivariable regression models were used to examine associations between ABA therapy exposure and hospitalization outcomes while adjusting for demographic characteristics and comorbidities identified using the Pediatric Complex Chronic Conditions algorithm. This research addresses critical gaps in understanding how evidence-based interventions and system-level factors are associated with hospital utilization among children and youth with ASD. Findings are expected to inform health policy, payer strategies, and care coordination models aimed at reducing avoidable hospitalizations, improving equity in access to autism care, and advancing value-based approaches for ASD service delivery.

Rights

Copyright is held by the author. All rights reserved.

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