TY  - JOUR
PY  - 2018//
TI  - The epidemiology of pediatric head injury treated outside of hospital emergency departments
JO  - Epidemiology
A1  - Zogg, Cheryl K.
A1  - Haring, R. Sterling
A1  - Xu, Likang
A1  - Canner, Joseph K.
A1  - Alsulaim, Hatim A.
A1  - Hashmi, Zain G.
A1  - Salim, Ali
A1  - Engineer, Lilly D.
A1  - Haider, Adil H.
A1  - Bell, Jeneita M.
A1  - Schneider, Eric B.
SP  - 269
EP  - 279
VL  - 29
IS  - 2
N2  - BACKGROUND: Although head trauma-related deaths, hospitalizations, and emergency department visits are well characterized, few studies describe pediatric patients presenting outside of emergency departments. We compared the epidemiology and extent of healthcare-seeking pediatric (0-17y) patients presenting in outpatient settings with those of patients seeking non-hospitalized emergency department care. <br><br>METHODS: We used MarketScan Medicaid and commercial claims, 2004-2013, to identify patients managed in two outpatient settings (physician's offices/clinics, urgent care) and the emergency department. We then examined differences in demographic and injury-specific factors, CDC-defined head trauma diagnoses, the extent of and reasons for post-index visit ambulatory care use within 30/90/180 days, and annual and monthly variations in head trauma trends. Outpatient incidence rates in 2013 provided estimates of the nationwide US outpatient burden. <br><br>RESULTS: A total of 1,683,097 index visits were included, representing a nationwide burden in 2013 of 844,660 outpatient cases, a number that encompassed 51% of healthcare-seeking head trauma that year and that substantially increased in magnitude from 2004-2013. Two-thirds (68%) were managed in outpatient settings. While demographic distributions varied with index-visit location, injury-specific factors were comparable. Seasonal spikes appeared to coincide with school sports. <br><br>CONCLUSIONS: There is an urgent need to better understand the natural history of head trauma in the >800,000 pediatric patients presenting each year for outpatient care. These outpatient injuries, which are more than double the number of head trauma cases recorded in the hospital-affiliated settings, illustrate the potential importance of expanding inclusion criteria in surveillance and prevention efforts designed to address this critical issue.<p />  <p>Language: en</p>
LA  - en
SN  - 1044-3983
UR  - http://dx.doi.org/10.1097/EDE.0000000000000791
ID  - ref1
ER  -