Citation

Spaw AJ, Lundine JP, Johnson SA, Peng J, Wheeler KK, Shi J, Yang G, Haley KJ, Groner JI, Xiang H. J. Head Trauma Rehabil. 2018; 33(3): E1-E10.

Affiliation

The Ohio State University College of Medicine (Ms Spaw and Drs Yang, Groner, and Xiang), Division of Clinical Therapies, Nationwide Children's Hospital (Dr Lundine), Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital (Mss Johnson, Wheeler, and Haley, and Drs Peng, Shi, Yang, Groner, and Xiang), Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital (Ms Johnson and Wheeler and Drs Peng, Shi, Yang, and Xiang), College of Public Health, The Ohio State University (Dr Peng), and Trauma Program, Nationwide Children's Hospital (Ms Haley and Dr Groner), Columbus, Ohio.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/HTR.0000000000000314

PMID

28520664

Abstract

OBJECTIVE: To investigate factors associated with follow-up care adherence in children hospitalized because of traumatic brain injury (TBI).

DESIGN: An urban level 1 children's hospital trauma registry was queried to identify patients (2-18 years) hospitalized with a TBI in 2013 to 2014. Chart reviewers assessed discharge summaries and follow-up instructions in 4 departments. MAIN MEASURES: Three levels of adherence-nonadherence, partial adherence, and full adherence-and their associations with care delivery, patient, and injury factors.

RESULTS: In our population, 80% were instructed to follow up within the hospital network. These children were older and had more severe TBIs than those without follow-up instructions and those referred to outside providers. Of the 352 eligible patients, 19.9% were nonadherent, 27.3% were partially adherent, and 52.8% were fully adherent. Those recommended to follow up with more than 1 department had higher odds of partial adherence over nonadherence (adjusted odds ratio [AOR] = 5.8, 95% CI: 1.9-17.9); however, these patients were less likely to be fully adherent (AOR = 0.1; 95% CI: 0.1-0.3). Privately insured patients had a higher AOR of full adherence.

CONCLUSIONS: Nearly 20% of children hospitalized for TBI never returned for outpatient follow-up and 27% missed appointments. Care providers need to educate families, coordinate service provision, and promote long-term monitoring.

Language: en