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Newton A, Yang J, Shi J, Sullivan L, Huang L, Singichetti B, Zhu M, Felix AS. Sports and non-sports-related concussions among Medicaid-insured children: health care utilization before and after Ohio's concussion law. Inj Epidemiol 2020; 7:55. [PMID: 33131503 PMCID: PMC7604964 DOI: 10.1186/s40621-020-00283-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 09/11/2020] [Indexed: 11/10/2022] Open
Abstract
Objective To evaluate patterns of health care utilization for sports-related concussions (SRCs) and non-sports-related concussions (NSRCs) among Medicaid-insured children before and after the enactment of Ohio’s concussion law in April 2013. Methods We analyzed claim data from the Partners For Kids (PFK) Ohio Medicaid database. Concussion diagnoses were identified between April 1, 2008 and June 30, 2017. We compared frequency of concussions by age and sex across the law period. We evaluated type of health care utilization before and after law enactment using multinomial logistic regression. Results Over the 9 year study period, 6157 concussions were included, most of which (70.4%) were NSRCs. The proportion of SRCs increased with age. Among children younger than 5 years old, the majority (96.1%) of concussions were NSRCs. During the post-law period, greater odds of primary care visits than emergency department (ED) visits were observed for both SRCs (OR = 1.53; 95% CI 1.34, 1.75) and NSRCs (OR = 1.73; 95% CI 1.58, 1.90) compared to the pre-law period. Conclusions We observed higher proportions of health care utilization for NSRCs than SRCs in Medicaid insured children and a shift in health care utilization from the ED to primary care in the post-law period. SRCs and NSRCs are likely to have different patterns of health care utilization before and after the enactment of Ohio’s concussion law. Our results demonstrate that Ohio’s youth concussion law had a quantifiable impact on health care utilization.
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Affiliation(s)
- Alison Newton
- Center for Injury Research and Policy, Nationwide Children's Hospital, 700 Children's Drive - RBIII, Columbus, OH, 43205, USA.,College of Public Health, Department of Epidemiology, Ohio State University, Columbus, OH, USA
| | - Jingzhen Yang
- Center for Injury Research and Policy, Nationwide Children's Hospital, 700 Children's Drive - RBIII, Columbus, OH, 43205, USA. .,College of Public Health, Department of Epidemiology, Ohio State University, Columbus, OH, USA.
| | - Junxin Shi
- Biostatistics Resource at Nationwide Children's Hospital, Columbus, OH, USA
| | - Lindsay Sullivan
- Center for Injury Research and Policy, Nationwide Children's Hospital, 700 Children's Drive - RBIII, Columbus, OH, 43205, USA
| | - Lihong Huang
- Center for Injury Research and Policy, Nationwide Children's Hospital, 700 Children's Drive - RBIII, Columbus, OH, 43205, USA
| | - Bhavna Singichetti
- Center for Injury Research and Policy, Nationwide Children's Hospital, 700 Children's Drive - RBIII, Columbus, OH, 43205, USA
| | - Motao Zhu
- Center for Injury Research and Policy, Nationwide Children's Hospital, 700 Children's Drive - RBIII, Columbus, OH, 43205, USA.,College of Public Health, Department of Epidemiology, Ohio State University, Columbus, OH, USA
| | - Ashley S Felix
- College of Public Health, Department of Epidemiology, Ohio State University, Columbus, OH, USA
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