DOI: 10.5061/dryad.vq83bk47t
title: Data from: Comparing autistic and non-autistic older adults' fall-related hospitalization care and outcomes

description: Older adults are at high risk for fall-related hospitalizations, yet
 little is known about care processes and outcomes for autistic older
 adults. This study compared fall-related hospitalization outcomes between
 autistic and non-autistic older adults. Using 2013–2021 Medicare inpatient
 claims, we conducted a retrospective cohort study of beneficiaries aged ≥
 65 hospitalized for a fall. Autistic older adults were identified using
 ICD codes and matched 1:1 to non-autistic peers on demographic, clinical,
 and geographic factors. Outcomes included length of stay (LOS), receipt of
 inpatient occupational therapy (OT) or physical therapy (PT), discharge
 destination, and all-cause 30-day readmission. Multivariable models,
 stratified by age, adjusted for sociodemographic, clinical, and contextual
 covariates. Sensitivity analyses controlled for dual Medicaid eligibility.
 Autistic older adults had longer LOS and were less likely to receive OT
 during hospitalization than matched non-autistic peers. They were less
 often discharged home or to inpatient rehabilitation and were more likely
 to be discharged to a skilled nursing facility. Autistic older adults also
 had an 18% higher risk of 30-day readmission. Age-stratified and
 sensitivity analyses yielded similar patterns. Autistic older adults
 hospitalized for falls experience longer stays, lower access to
 rehabilitative services, less favorable discharge destinations, and higher
 readmission risk compared to non-autistic peers. These disparities
 highlight the need to improve access to OT, PT, and post-acute supports
 for autistic older adults and to better understand barriers to equitable
 fall-related care.
description: # Data from: Comparing autistic and non-autistic older adults'
 fall-related hospitalization care and outcomes Dataset DOI:
 [10.5061/dryad.vq83bk47t](https://doi.org/10.5061/dryad.vq83bk47t)
 \-------------------------------------------------------------------------------- PROJECT OVERVIEW \-------------------------------------------------------------------------------- This project uses Medicare claims data (Parts A & B) to compare autistic and non-autistic older adults' fall-related hospitalization care and outcomes. Key components: \- Data Cleaning: Prepares raw Medicare claims data for analysis. \- SAS Macros: Creates table 1 and calculates effect size. \- Table Generation: Produces descriptive and outcome table for cohort. \- Matched Cohort Analysis: Uses propensity-score matching (1 autistic : ~2 non-autistic ratio). NOTE: This project uses restricted Medicare data that requires CMS Data Use Agreement (DUA) approval. The datasets cannot be shared publicly. \-------------------------------------------------------------------------------- TOOLS AND DEPENDENCIES \-------------------------------------------------------------------------------- \- Language: SAS v9.4 \- Required Access: Secure server with Medicare Parts A & B claims files \- Matching Method: Variable-ratio propensity score matching \- Required SAS Macros: Ensure "4. Table 1 Macro - Two Dec.sas" and "5. Effect Size Macro.sas" is saved in the working directory before running table generation and multivariable analyses scripts. \-------------------------------------------------------------------------------- FILE DESCRIPTIONS \-------------------------------------------------------------------------------- `1._Find_Severe_Fall_Dates_and_Disposition.sas` Locates first severe fall date and disposition `2._Data_Cleaning_Part_1.sas`: Cleans and prepares raw Medicare data (step 1) `3._Data_Cleaning_Part_2.sas`: Finalizes analytic datasets (step 2) `4._Table_1_Macro_-_Two_Dec.sas`: Macro to produce descriptive statistics `5._Effect_Size_Macro.sas` Macro to produce effect sizes `6._Multivariable_Analyses.sas` Runs models for cohort `7._Table_1_Creation.sas`: Generates descriptive statistics for cohort `Differences_in_Hospital_Outcomes_for_Severe_Falls_Data_Dictionary.docx`: Variable names and definitions `READme.txt`: Project overview and instructions `Differences_in_Hospital_Outcomes_for_Severe_Falls_Data_Dictionary.pdf`: PDF version of the prior file with same filename \-------------------------------------------------------------------------------- HOW TO RUN \-------------------------------------------------------------------------------- /* Step 1: Data Cleaning */ Run the file "1. Find Severe Fall Dates and Disposition.sas" Run the file "2. Data Cleaning Part 1.sas" Run the file "3. Data Cleaning Part 2.sas" /* Step 2: Save Macros */ Run the file "4. Table 1 Macro - Two Dec.sas" Rn the file "5. Effect Size Macro.sas" /* Step 3: Multivariable Models and Tables*/ Run the file "6. Multivariable Analysis Matched.sas" Run the file "7. Table 1 Creation.sas" \-------------------------------------------------------------------------------- OUTPUTS \-------------------------------------------------------------------------------- `Table 1 MB 28Jan2025.rtf`: Descriptive statistics for matched cohort \-------------------------------------------------------------------------------- DATA USE DISCLAIMER \-------------------------------------------------------------------------------- Medicare data are protected under CMS Data Use Agreements. This repository does NOT include raw data. Users must obtain appropriate DUA approval to access Medicare claims. \-------------------------------------------------------------------------------- CITATION \-------------------------------------------------------------------------------- If you use this project or scripts, we kindly request that you consider citing: Blake, M., Nikahd, M., Hyer, J. M., Patterson, B. W., Wolf, B. J., Bishop, L., & Hand, B. N. (2025). Comparing Autistic and Non-Autistic Older Adults' Fall-Related Hospitalization Care and Outcomes. Journal of general internal medicine, 10.1007/s11606-025-09933-5. Advance online publication. [https://doi.org/10.1007/s11606-025-09933-5](https://doi.org/10.1007/s11606-025-09933-5)