OBJECTIVE: To compare the healthcare use by children with and without a traumatic brain injury (TBI) in the year following injury to understand whether children access primary care. PARTICIPANTS: Children 0 to 15 years with a TBI (N = 545) and (N = 2310) uninjured age and sex-matched comparisons. SETTING: A full benefits healthcare plan from 2000 to 2007. MAIN MEASURES: Mean annual healthcare utilization. RESULTS: Children with TBI had higher mean annual outpatient visits (4.2 vs. 3.5, P = .001), but similar mean annual general pediatric visits (2.7 vs. 2.8, P = .3) than comparison children. More cases than comparisons attended a general pediatric visit (80.0% vs. 73.3%, risk ratio = 1.1, 95% CI: 1.0-1.1). However, approximately 50% of children older than 7 years who had an intracranial injury did not attend a general pediatric visit and those were slightly more likely to receive specialty care (adjusted risk ratio = 1.1, 95% CI: 1.0-1.2). These children did not appear to be substituting specialty for primary care. CONCLUSIONS: Children with a full benefits insurance plan do not access primary care routinely after TBI. These findings present a challenge for designing a system to screen children after TBI.
OBJECTIVE: To compare the healthcare use by children with and without a traumatic brain injury (TBI) in the year following injury to understand whether children access primary care. PARTICIPANTS: Children 0 to 15 years with a TBI (N = 545) and (N = 2310) uninjured age and sex-matched comparisons. SETTING: A full benefits healthcare plan from 2000 to 2007. MAIN MEASURES: Mean annual healthcare utilization. RESULTS:Children with TBI had higher mean annual outpatient visits (4.2 vs. 3.5, P = .001), but similar mean annual general pediatric visits (2.7 vs. 2.8, P = .3) than comparison children. More cases than comparisons attended a general pediatric visit (80.0% vs. 73.3%, risk ratio = 1.1, 95% CI: 1.0-1.1). However, approximately 50% of children older than 7 years who had an intracranial injury did not attend a general pediatric visit and those were slightly more likely to receive specialty care (adjusted risk ratio = 1.1, 95% CI: 1.0-1.2). These children did not appear to be substituting specialty for primary care. CONCLUSIONS:Children with a full benefits insurance plan do not access primary care routinely after TBI. These findings present a challenge for designing a system to screen children after TBI.
Authors: Janessa M Graves; Jessica L Mackelprang; Megan Moore; Demetrius A Abshire; Frederick P Rivara; Nathalia Jimenez; Molly Fuentes; Monica S Vavilala Journal: Health Serv Res Date: 2018-12-03 Impact factor: 3.402
Authors: Jonathan N Dodd; Trevor A Hall; Kristin Guilliams; Réjean M Guerriero; Amanda Wagner; Sara Malone; Cydni N Williams; Mary E Hartman; Juan Piantino Journal: Pediatr Neurol Date: 2018-09-18 Impact factor: 3.372
Authors: Andrea R S Huebner; Amy Cassedy; Tanya M Brown; H Gerry Taylor; Terry Stancin; Michael W Kirkwood; Shari L Wade Journal: PM R Date: 2017-10-31 Impact factor: 2.298