Disparities in Outpatient Clinic Visits Following Treatment of Concussion in the Emergency Setting
Autumn Nanassy, BA,MS; Erika Lindholm, MD; Sean Ciullo, MD; Rajeev Prasad, MD; L. Grier Arthur, MD; Harsh Grewal, MD
St. Christopher's Hospital for Children, Philadelphia, PA
Background: The rate of emergency department visits for concussion in children has more than doubled over the past five years. Symptoms of concussion may last for a few hours, or an entire lifetime. Given the potential harm associated with these injuries and the rise in incidence, the factors promote follow-up in outpatient clinic should be examined. We south to examine how demographics and socioeconomic variables may predict follow-up in an urban, level I pediatric trauma center.
Methods: Retrospective chart review of pediatric patients followed in post-concussive clinic between 2010-2013 was conducted to determine predictors of compliance. Demographic, socioeconomic, and geographic patient variables were recorded.
Results: There were 107 patients included with average age 11.9 years (6 weeks – 18 years) with 65% males. Patients kept approximately two outpatient visits (M = 2.43; SD = 4.84). Male patients were likely to follow-up sooner than female patients (5 days vs. 8 days). Zip code, type of insurance, and number of injuries a patient experienced were significant predictors of the number of follow-up appointments kept with post-concussive clinic (p<0.05).
Conclusion: Results suggest that socioeconomic status may be a predictor of TBI-related injury follow-up. Both zip code and type of insurance injury were predictors of number of kept appointments. This suggests that socioeconomic status is a predictor of patient follow-up. In addition, the number of injuries predicted number of appointments, which shows allocation of resources towards sickest patients.
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