Research Reports - Healthcare utilization in the first year after pediatric traumatic brain injury in an insured population

J Head Trauma Rehabil. 2012 Jun 9

Keenan HT, Murphy NA, Staheli R, Savitz LA

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.

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