Factors Influencing Timely Diagnosis of Autism in China: an Application of Andersen's Behavioral Model of Health Services Use
Overview
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Background: Timely diagnosis of autism is pivotal for accessing crucial supports and services. However, achieving it remains a persistent challenge, particularly in countries like China where the healthcare system is characterized by its intricate network and often resulting in fragmented care delivery and disparities in access.
Methods: A cross-sectional questionnaire survey was conducted among families with autistic children aged between 1 and 17 years in Chinese Mainland. Andersen's Behavioral Model guided the assessment of predisposing, enabling, and need factors.
Results: The study revealed that 86.24% of Chinese children did not receive a formal diagnosis until after 24 months, with an average gap of 10.93 months between parents/caregivers' initial concerns and diagnostic confirmation. Predisposing factors of the child's current age emerged as a significant predictor for timely diagnosis. Enabling factors, including residence-hospital distance and experience of misdiagnosis were significant. Additionally, the severity level at diagnosis was identified as a predictor for timely diagnosis.
Conclusions: Our findings revealed that predisposing, enabling, and need factors contributed to the complex landscape of autism diagnosis in China. Strategies including implementing routine screening programs and adopting a multidisciplinary approach are crucial for timely identification and diagnosis, particularly for mild and moderate cases. Additionally, there is an urgent need for specialized autism training for healthcare professionals, the development of structured referral systems, and the expansion of telehealth solutions to ensure equitable access to diagnosis services across regions. By addressing these challenges, policymakers and healthcare providers can improve the accessibility and timeliness of autism diagnosis, ultimately enhancing the quality of life for affected individuals and their families.