1. Introduction to the Paediatric Break-Out Session.

3. Paediatric Health in Cayman Increase in children diagnosed with learning disabilities, specifically autism spectrum disorders (ASD’s). High proportion of the paediatric population are either over-weight or are obese.

5. Prevalence of ASD’s Prevalence is estimated at 1 in 88 births 1 percent of the population of children in the U.S. ages 3-17 have an autism spectrum disorder. ASD’s are the fastest-growing developmental disability - with a rate of 148% increase. GlobalData. (2010). Autistic Disorder - Pipeline Assessment and Market Forecasts to 2017 (p. 37)

6. Economic Costs Individuals with an ASD had average medical expenditures that exceeded those without an ASD by $4,110 - $6,200 per year. On average, medical expenditures for individuals with an ASD were 4.1 - 6.2 times greater than for those without an ASD. In 2005, the average annual medical costs for Medicaid-enrolled children with an ASD were $10,709 per child, which was about six times higher than costs for children without an ASD ($1,812). In addition to medical costs, intensive behavioral interventions for children with ASDs cost $40,000 to $60,000 per child per year.

7. Students on a Phase 3 IEP (June 2012)

8. The Vicious Cycle of Childhood Obesity

9. Economic Costs of Childhood Obesity Annual medical costs for a child diagnosed with obesity are on average three times higher than those for a child who is not overweight or obese. In the U.S. it is estimated that annual costs for prescription drugs, emergency room treatment and outpatient services related to childhood obesity total more than $14 billion, with an additional $238 million in inpatient hospital costs. Research shows that obese children are more than three times as likely to be hospitalized as those who are not obese.

10. School Entry Screening: Ages 3-6 years old

11. School Screenings: Ages 10-14 years old

12. Public V’s Private Medical Sectors Public Sector Pros: Majority of services provided under the same umbrella Patient may be seen by several different doctors Cons: Patient may be seen by several different doctors Loss of continuity Longer waiting lists Greater demand on limited resources Private Sector Pros: Patient continuity Very accessible Shorter waiting times Cons: Expensive for non-insured or CINICO patients ‘Doctor Shopping’ Isolated care

13. Cayman Specialists V’s Overseas Specialists

14. Patient Perspective Strengths Most services very accessible Weaknesses Overseas referrals Stigma associated with certain conditions Health insurance coverage Pharmacy shortage Opportunities Freedom to obtain a second opinion Threats Insurance coverage Lack of services (Ped OT) Financial Restraints

15. Medical Professional’s Perspective Strengths Small community - easy to contact other health care providers or community support Weaknesses Health Insurance Lack of local training Lack of research Lack of protocols Opportunities Increased community awareness - Children’s Task Force SNCF Threats Private sector rivalry ‘Doctor shopping’ Lack of parent participation Parent denial

16. Ways to assist with the SWOT analysis Produce more statistics/Central registry Health Insurance Reform Express the need for extra support services Provide local training Fund research projects

17. Next steps for Paediatric Health Insurance Reform Alternatives for un-insured conditions/patients Consistent standards/referral protocols Consistent developmental screening Better links between health care and education More community education programs Increased awareness of support groups