Socioeconomic and demographic considerations of pediatric concussion recovery. (June 2022)

• Record Type: Journal Article
• Authors: Pate, James; Cummins, Ian; Mooney, James; Cooper, Kasey; McLeod, Chandler; Gould, Sara
• Is Part Of: Journal of clinical neuroscience. Volume 100(2022)
• Page Start: 94
• Page End: 99
• Publication Date: 2022-06
• Subjects: Concussion -- Mild traumatic brain injury -- Post-traumatic headaches -- Recovery -- Socioeconomic disparities; Brain -- Surgery -- Periodicals; Neurosciences -- Periodicals; Nervous system -- Surgery -- Periodicals; Brain -- surgery -- Periodicals; Neurosurgical Procedures -- Periodicals; Neurosciences -- Periodicals; Electronic journals; 616.8
• DOI: 10.1016/j.jocn.2022.04.008
• Languages: English
• ISSNs: 0967-5868

Abstract

Highlights: Children were more likely to be hospitalized after concussion than adolescents. Concussion clinic patients were more likely to have private insurance. White patients constituted a larger portion of concussion clinic visits. Black patients constituted a larger portion of pediatric ED visits for concussion. Potential barriers to care for youth concussion patients need be addressed. Abstract: The objective of this study was to investigate predictors of concussion recovery in children (5–12) versus adolescents (13–18) while identifying economic and demographic disparities in post-concussion care at a tertiary referral concussion clinic versus emergency department (ED). Race and insurance status were recorded for patients presenting to the concussion clinic (724) and ED (1, 160) with an ICD-10 concussion diagnosis between 2018 and 2019. Secondly, a subset of patients from the concussion clinic group were included for retrospective cohort review based on documented recovery data. Overall, the concussion clinic saw more Caucasian patients (66.7%) than the ED (56.8%). Concussion clinic patients were more likely to have Private insurance than ED patients (67.2% vs. 55.3%) and less likely to have Medicaid and Self pay (p < 0.001). Children were more likely to be hospitalized after concussion diagnosis than adolescents (40.8% vs. 24.4%, p = 0.006). Attending public school was associated with a 1.8 times greater hazard ratio (HR) for shorter time to recovery compared to attending private school. Additionally, presence of a diagnosed psychiatric disorder was associated with a HR of 0.5, indicating a longer time to recovery (p < 0.001) than patients without a disorder. The present findings may support limitations on contact sports participation in young children given their higher hospitalization rate after concussion. Additionally, the study highlights potential barriers to care amongst youth concussion patients with those seen in specialized concussion clinics more likely to be White and have private insurance.