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Initial Emergency Department Visit and Follow-Up Care for Concussions among Children with Medicaid.
- Source :
-
The Journal of pediatrics [J Pediatr] 2019 Mar; Vol. 206, pp. 178-183. Date of Electronic Publication: 2018 Nov 12. - Publication Year :
- 2019
-
Abstract
- Objective: To describe the rates and patterns of initial emergency department (ED) encounters and follow-up care for concussions among Medicaid-insured children before and after the 2013 enactment of Ohio concussion law.<br />Study Design: Using a time-series design, this study analyzed concussion claim data obtained from Partners for Kids, a pediatric accountable-care organization in Ohio. A total of 12 512 concussions and 48 238 associated claims for services between January 1, 2008, and June 30, 2017, with an initial ED encounter among Medicaid-insured children (ages 0-18 years) were analyzed. The effect of the law on the odds of follow-up care were assessed using generalized estimating equations models, adjusted for sex, age group, and residence location.<br />Results: Of the total 12 512 concussions, 63.9% occurred in male patients, 70.1% in patients ages 10-18 years, and 65.2% in patients from urban areas. The rate of initial ED encounters for concussions increased from 2008 to 2014 (2.8 to 4.9 per 10 000 members), followed by a decrease in 2016 (4.2 per 10 000 members). A significant increase in follow-up care after the initial ED encounter was observed from pre-law to post-law (OR 1.73, 95% CI 1.61, 1.86). A shift in follow-up care was observed from radiology and ambulance services in pre-law to primary care providers in post-law.<br />Conclusions: The Ohio concussion law may have influenced the patterns of initial ED visit and follow-up care for concussions among Medicaid-insured children. Future studies evaluating the impact of the law should analyze the utilization patterns among children with various insurance/payment types.<br /> (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Aftercare legislation & jurisprudence
Brain Concussion diagnosis
Brain Concussion epidemiology
Child
Child, Preschool
Emergency Service, Hospital legislation & jurisprudence
Facilities and Services Utilization
Female
Humans
Infant
Infant, Newborn
Male
Ohio
Primary Health Care legislation & jurisprudence
United States
Aftercare statistics & numerical data
Brain Concussion therapy
Emergency Service, Hospital statistics & numerical data
Medicaid
Primary Health Care statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1097-6833
- Volume :
- 206
- Database :
- MEDLINE
- Journal :
- The Journal of pediatrics
- Publication Type :
- Academic Journal
- Accession number :
- 30442410
- Full Text :
- https://doi.org/10.1016/j.jpeds.2018.10.021