Patterns and Predictors of Health Care Utilization After Pediatric Concussion: A Retrospective Cohort Study.
OBJECTIVE: To characterize types, duration, and intensity of health care utilization following pediatric concussion and to identify risk factors for increased post-concussion utilization. METHODS: A retrospective cohort study of children 5 to 17 years old diagnosed with acute concussion at a quatern...
| Publicado en: | Academic Pediatrics Vol. 24; no. 1; pp. 51 - 59 |
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| Autores principales: | , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Elsevier B.V.
Jan/Feb2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=175060125&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 175060125 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18762859 8NBK jtl: Academic Pediatrics issn: 18762859 maglogo: N pubinfo: dt: Jan/Feb2024 vid: 24 iid: 1 pid: 467 pub: Elsevier B.V. place: New York, New York artinfo: ui: 175060125 175060125 175060125 10.1016/j.acap.2023.04.010 175060125 ppf: 51 ppct: 8 formats: fmt: @attributes: type: P tig: atl: Patterns and Predictors of Health Care Utilization After Pediatric Concussion: A Retrospective Cohort Study. aug: au: Meyer, Erin J. Trudell Correa, Emily Monuteaux, Michael C. Mannix, Rebekah Hatoun, Jonathan Vernacchio, Louis Lyons, Todd W. affil: Division of Emergency Medicine, Boston Children's Hospital and Harvard Medical School, Mass sug: subj: Brain Concussion In Infancy and Childhood Health Resource Utilization Evaluation Health Services Accessibility Human Retrospective Design Prospective Studies Child Adolescence Logistic Regression Descriptive Statistics Odds Ratio Confidence Intervals Patient Centered Care Male Female Child: 6-12 years Adolescent: 13-18 years Male Female ab: OBJECTIVE: To characterize types, duration, and intensity of health care utilization following pediatric concussion and to identify risk factors for increased post-concussion utilization. METHODS: A retrospective cohort study of children 5 to 17 years old diagnosed with acute concussion at a quaternary center pediatric emergency department or network of associated primary care clinics. Index concussion visits were identified using International Classification of Diseases, Tenth Revision, Clinical Modification codes. We analyzed patterns of health care visits 6 months before and after the index visit using interrupted time-series analyses. The primary outcome was prolonged concussion-related utilization, defined as having ≥1 follow-up visits with a concussion diagnosis more than 28 days after the index visit. We used logistic regressions to identify predictors of prolonged concussion-related utilization. RESULTS: Eight hundred nineteen index visits (median [interquartile range] age, 14 [11-16] years; 395 [48.2%] female) were included. There was a spike in utilization during the first 28 days after the index visit compared to the pre-injury period. Premorbid headache/migraine disorder (adjusted odds ratio (aOR) 2.05, 95% confidence interval [CI] 1.09-3.89) and top quartile pre-injury utilization (aOR 1.90, 95% CI 1.02-3.52) predicted prolonged concussion-related utilization. Premorbid depression/anxiety (aOR 1.55, 95% CI 1.31-1.83) and top quartile pre-injury utilization (aOR 2.29, 95% CI 1.95-2.69) predicted increased utilization intensity. CONCLUSIONS: Health care utilization is increased during the first 28 days after pediatric concussion. Children with premorbid headache/migraine disorders, premorbid depression/ anxiety, and high baseline utilization are more likely to have increased post-injury health care utilization. This study will inform patient-centered treatment but may be limited by incomplete capture of post-injury utilization and generalizability. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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