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Quantifying their early health system utilization could uncover condition-specific health trajectories to facilitate earlier detection and intervention. Patients born 10\/1\/2006\u201310\/1\/2016 with\u2009\u2265\u20092 well-child visits within the Duke University Health System before age 1 were grouped as ASD, ADHD, ASD\u2009+\u2009ADHD, or No Diagnosis using retrospective billing codes. An additional comparison group was defined by later upper respiratory infection diagnosis. Adjusted odds ratios (AOR) for hospital admissions, procedures, emergency department (ED) visits, and outpatient clinic encounters before age 1 were compared between groups via logistic regression models. Length of hospital encounters were compared between groups via Mann\u2013Whitney <jats:italic>U<\/jats:italic> test. In total, 29,929 patients met study criteria (ASD N\u2009=\u2009343; ADHD N\u2009=\u20091175; ASD\u2009+\u2009ADHD N\u2009=\u2009140). ASD was associated with increased procedures (AOR\u2009=\u20091.5, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), including intubation and ventilation (AOR\u2009=\u20092.4, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); and outpatient specialty care, including physical therapy (AOR\u2009=\u20093.5, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and ophthalmology (AOR\u2009=\u20093.1, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). ADHD was associated with increased procedures (AOR\u2009=\u20091.41, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), including blood transfusion (AOR\u2009=\u20094.7, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); hospital admission (AOR\u2009=\u20091.60, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); and ED visits (AOR\u2009=\u20091.58, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). Median length of stay was increased after birth in ASD (+\u20096.5\u00a0h, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and ADHD (+\u20093.8\u00a0h, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and after non-birth admission in ADHD (+\u20091.1 d, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001) and ASD\u2009+\u2009ADHD (+\u20092.4 d, <jats:italic>p<\/jats:italic>\u2009=\u20090.003). Each condition was associated with increased health system utilization and distinctive patterns of utilization before age 1. Recognizing these patterns may contribute to earlier detection and intervention.<\/jats:p>","DOI":"10.1038\/s41598-020-74458-2","type":"journal-article","created":{"date-parts":[[2020,10,19]],"date-time":"2020-10-19T10:09:45Z","timestamp":1603102185000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Health system utilization before age 1 among children later diagnosed with autism or ADHD"],"prefix":"10.1038","volume":"10","author":[{"given":"Matthew M.","family":"Engelhard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel I.","family":"Berchuck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jyotsna","family":"Garg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Henao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Olson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley","family":"Rusincovitch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geraldine","family":"Dawson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott H.","family":"Kollins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,10,19]]},"reference":[{"issue":"6","key":"74458_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss6706a1","volume":"67","author":"J Baio","year":"2018","unstructured":"Baio, J. et al. 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Dawson has developed technology that has been licensed and Dawson and Duke University have benefited financially. Dawson receives royalties from Guilford Press, Springer, and Oxford University Press. Scott Kollins reports grants, personal fees and non-financial support from Akili Interactive; grants, personal fees and non-financial support from Arbor Pharmaceuticals; grants, personal fees and non-financial support from Bose; grants, personal fees and non-financial support from Otsuka Pharmaceuticals; grants, personal fees and non-financial support from Rhodes; grants, personal fees and non-financial support from Shire Pharmaceuticals; and grants, personal fees and non-financial support from Tris Pharmaceuticals outside the submitted work. Matthew Engelhard, Samuel Berchuck, Jyotsna Garg, Ricardo Henao, Andrew Olson, and Shelley Rusincovitch have no financial relationships or potential conflicts of interest relevant to this article.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"17677"}}