Sports and non-sports-related concussions among Medicaid-insured children: health care utilization before and after Ohio
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Sports and non-sports-related concussions among Medicaid-insured children: health care utilization before and after Ohio’s concussion law Alison Newton1,2, Jingzhen Yang1,2* , Junxin Shi3, Lindsay Sullivan1, Lihong Huang1, Bhavna Singichetti1, Motao Zhu1,2 and Ashley S. Felix2
Abstract Objective: To evaluate patterns of health care utilization for sports-related concussions (SRCs) and non-sportsrelated 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. Keywords: Pediatric, Traumatic brain injury, Legislation, Non-sports related injury
* Correspondence: [email protected] 1 Center for Injury Research and Policy, Nationwide Children’s Hospital, 700 Children’s Drive - RBIII, Columbus, OH 43205, USA 2 College of Public Health, Department of Epidemiology, Ohio State University, Columbus, OH, USA Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright h
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