@article{ref1,
title="Utilization of mental health services after mild pediatric traumatic brain injury",
journal="Pediatrics",
year="2017",
author="Jimenez, Nathalia and Quistberg, Duane Alexander and Vavilala, Monica S. and Jaffe, Kenneth M. and Rivara, Frederick P.",
volume="139",
number="3",
pages="e2016-2462",
abstract="BACKGROUND: Mild traumatic brain injury injuries (mTBIs), including concussions, represent >2 million US pediatric emergency department visits annually. Post-mTBI mental health symptoms are prominent and often attributed to the mTBI. This study examined whether individuals seeking post-mTBI mental health care had previous mental health diagnoses or a new onset of such disorders, and determined if mental health care utilization differed by race/ethnicity. <br><br>METHODS: Retrospective cohort study, using the Medicaid Marketscan claims national dataset (2007-2012). Utilization of mental health services 1 year before and 1 year after mTBI was compared between children with and without mental health diagnoses before injury. Primary outcome was receipt of post-mTBI outpatient mental health care. <br><br>RESULTS: A total of 31 272 children 20 years or younger were included, 8577 (27%) with mental health diagnoses before their mTBI and 22 695 without one. After injury, children without previous mental health disorders increased mental health services utilization; however, most (86%) postinjury mental health care was received by children with previous mental health disorders. Having a mental health diagnosis pre-mTBI was the most important risk factor for receiving post-mTBI mental health care (odds ratio 7.93, 95% confidence interval 7.40-8.50). Hispanic children were less likely to receive post-mTBI mental health care. <br><br>CONCLUSIONS: mTBI was associated with increased utilization of mental health services but most of these services were received by children with previous mental health disorders. Our documentation of racial/ethnic disparities in mental health care utilization reemphasize the importance of providing individualized, culturally, and linguistically competent care to improve outcomes after mTBI for all children.<br><br>Copyright © 2017 by the American Academy of Pediatrics.<p /> <p>Language: en</p>",
language="en",
issn="0031-4005",
doi="10.1542/peds.2016-2462",
url="http://dx.doi.org/10.1542/peds.2016-2462"
}