@article{ref1,
title="Factors associated with follow-up care after pediatric concussion: a longitudinal population-based study in Alberta, Canada",
journal="Frontiers in pediatrics",
year="2022",
author="Wittevrongel, Krystle and Barrett, Olesya and Hagel, Brent E. and Schneider, Kathryn J. and Johnson, David W. and Yeates, Keith Owen and Zwicker, Jennifer D.",
volume="10",
number="",
pages="e1035909-e1035909",
abstract="BACKGROUND: Concussion is a common injury in children and adolescents. Current best practice guidelines indicate that recovery should be supervised through recurrent follow-up visits. A more detailed understanding of the system-level and individual factors that are associated with follow-up care is a critical step towards increasing evidence-based practice. The objective of this study was to identify predisposing, enabling, and need-based factors associated with follow-up care after pediatric concussion. <br><br>MATERIALS AND METHODS: A retrospective population-based cohort study was conducted using linked, province-wide administrative health data for all patients <18 years of age with a diagnosis of concussion, other specified injuries of the head, unspecified injury of head, or post-concussion syndrome (PCS) between April 1, 2004 and March 31, 2018 in Alberta, Canada. The association between predisposing, enabling, and need-based factors and the receipt of follow-up care within a defined episode of care (EOC) was analyzed using logistic regression models for the entire cohort and for EOC that began with a concussion diagnosis. Predisposing factors included age and sex. Enabling factors included the community type of patient residence, area-based socioeconomic status (SES), and visit year. Need-based factors included where the EOC began (outpatient vs. emergency settings) and history of previous concussion-related EOC. <br><br>RESULTS: 194,081 EOCs occurred during the study period but only 13% involved follow-up care (n = 25,461). Males and adolescents were more likely to receive follow-up care. Follow-up was less likely among patients who lived in remote communities or in areas of lower SES, while EOCs beginning in 2011 or later were more likely to involve follow-up care. Patients whose EOC began in outpatient settings, had more than one EOC, or a diagnosis of concussion were more likely to receive follow-up care. <br><br>CONCLUSION: Follow-up care for pediatric concussion has increased over time and is associated with patient age and sex, history of concussion-related EOC, where a patient lives (community type and area-based SES), and when and where the index visit occurs. A better understanding of which children are more likely to receive follow-up care, as well as how and when they do, is an important step in aligning practice with follow-up guidelines.<p /> <p>Language: en</p>",
language="en",
issn="2296-2360",
doi="10.3389/fped.2022.1035909",
url="http://dx.doi.org/10.3389/fped.2022.1035909"
}