Journal
JOURNAL OF PEDIATRICS
Volume 192, Issue -, Pages 184-188Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2017.09.018
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Funding
- Ontario Child Health SPOR Support Unit (OCHSU)
- Institute for Clinical Evaluative Sciences (ICES)
- Ontario Ministry of Health and Long-Term Care (MOHLTC)
- Canadian Institutes of Health Research (CIHR) Chairs in Reproductive and Child Health Services and Policy Research [126341]
- Clinical Research Chair in Pediatric Concussion by the University of Ottawa
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Objective To assess whether children and youth with concussion receive follow-up visits in accordance with the recommended guidelines. Study design We conducted a retrospective, population-based study using linked health administrative data from all concussion-related visits to emergency department and physician offices by children aged 5 through 18 years (range, 5.00-18.99) in Ontario between 2003 and 2013. We analyzed the percentage of children and youth seen for follow-up. The Mann-Kendall test for trends was used to assess a monotonic increasing trend over time in concussion follow-up visits. Results A total of 126 654 children and youth were evaluated for an index concussion visit. The number of children and youth assessed for concussion follow-up (N = 45 155) has increased significantly over time (P < .001). In 2003, 781 of 7126 patients (11.0%; 95% CI, 10.3-11.7) with an index visit for concussion had a follow-up assessment. By 2013, 6526 of 21 681 (30.1%; 95% CI, 29.5-30.7) patients received follow-up care. Conclusions The proportion of children and youth receiving follow-up after an acute concussion has significantly increased between 2003 and 2013. Nevertheless, more than two-thirds of all patients do not seek medical follow-up or clearance as recommended by current concussion guidelines, suggesting that ongoing efforts to improve and monitor compliance with recommended guidelines by patients and physicians are important.
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