@article{ref1,
title="Patterns and predictors of healthcare utilization after pediatric concussion: a retrospective cohort study",
journal="Academic pediatrics",
year="2023",
author="Meyer, Erin J. and Correa, Emily Trudell and Monuteaux, Michael C. and Mannix, Rebekah and Hatoun, Jonathan and Vernacchio, Louis and Lyons, Todd W.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="OBJECTIVES: To characterize types, duration and intensity of healthcare utilization following pediatric concussion and to identify risk factors for increased post-concussion utilization. <br><br>METHODS: A retrospective cohort study of children 5-17 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 ICD-10-CM codes. We analyzed patterns of healthcare visits six 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. <br><br>RESULTS: 819 index visits (median [IQR] 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 (aOR 2.05, 95% 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. <br><br>CONCLUSIONS: Healthcare 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 healthcare utilization. This study will inform patient-centered treatment but may be limited by incomplete capture of post-injury utilization and generalizability.<p /> <p>Language: en</p>",
language="en",
issn="1876-2859",
doi="10.1016/j.acap.2023.04.010",
url="http://dx.doi.org/10.1016/j.acap.2023.04.010"
}