Influence of insurance type on rate and type of initial concussion-related medical visits among youth

BMC Public Health

Kenneth Jackson¹  Junxin Shi²  Chris Radlicz²  Amanda Hautmann²  Jingzhen Yang³ 

[1] Biostatistics Resource, Nationwide Children’s Hospital, Columbus, OH, USA;Center for Biostatistics, The Ohio State University, Columbus, OH, USA;Center for Injury Research and Policy, Nationwide Children’s Hospital, 700 Children’s Drive, RBIII-WB5403, 43205, Columbus, OH, USA;Center for Injury Research and Policy, Nationwide Children’s Hospital, 700 Children’s Drive, RBIII-WB5403, 43205, Columbus, OH, USA;Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, OH, USA;

关键词: Traumatic brain injury;    Insurance;    Health care utilization;    Children;   

DOI  :  10.1186/s12889-021-11586-y

来源: Springer

【 摘 要 】

BackgroundA growing number of studies report increased concussion-related health care utilization in recent years, but factors impacting care-seeking behaviors among youth following a concussion are not well described. This study aimed to evaluate the influence of insurance type on the rate and type of initial concussion visits and the time from injury to the initial visit in youth.MethodsWe extracted and analyzed initial concussion-related medical visits for youth ages 10 to 17 from electronic health records. Patients must have visited Nationwide Children’s Hospital’s (NCH) concussion clinic at least once between 7/1/2012 and 12/31/2017. We evaluated the trends and patterns of initial concussion visits across the study period using regression analyses.ResultsOf 4955 unique concussion visits included, 60.1% were males, 80.5% were white, and 69.5% were paid by private insurance. Patients’ average age was 13.9 years (SD = 3.7). The rate of the initial concussion visits per 10,000 NCH visits was consistently higher in privately insured than publicly insured youth throughout the study period (P < .0001). Privately insured youth had greater odds of initial concussion visits to sports medicine clinics (AOR = 1.45, 95% CI = 1.20, 1.76) but lower odds of initial concussion visits to the ED/urgent care (AOR = 0.74, 95% CI = 0.60, 0.90) than publicly insured youth. Days from injury to initial concussion visit significantly decreased among both insurance types throughout the study (P < .0001), with a greater decrease observed in publicly insured than privately insured youth (P = .011).ConclusionsResults on the differences in the rate, type, and time of initial concussion-related visits may help inform more efficient care of concussion among youth with different types of insurance.

【 授权许可】

CC BY