Newton Alison, Yang Jingzhen, Shi Junxin, Sullivan Lindsay, Huang Lihong, Singichetti Bhavna, Zhu Motao, Felix Ashley S
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.
Inj Epidemiol. 2020 Nov 2;7(1):55. doi: 10.1186/s40621-020-00283-w.
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.
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.
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.
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.
评估2013年4月俄亥俄州脑震荡法颁布前后，医疗补助保险儿童中与运动相关脑震荡（SRC）和非运动相关脑震荡（NSRC）的医疗保健利用模式。
我们分析了俄亥俄州儿童伙伴关系（PFK）医疗补助数据库中的索赔数据。在2008年4月1日至2017年6月30日期间确定脑震荡诊断。我们比较了整个法律实施期间按年龄和性别的脑震荡发生率。我们使用多项逻辑回归评估法律颁布前后的医疗保健利用类型。
在9年的研究期间，共纳入6157例脑震荡，其中大多数（70.4%）为NSRC。SRC的比例随年龄增加。在5岁以下的儿童中，大多数（96.1%）脑震荡为NSRC。在法律实施后期间，与法律实施前相比，SRC（OR = 1.53；95% CI 1.34, 1.75）和NSRC（OR = 1.73；95% CI 1.58, 1.90）的初级保健就诊几率高于急诊就诊几率。
我们观察到，在医疗补助保险儿童中，NSRC的医疗保健利用率高于SRC，并且在法律实施后期间，医疗保健利用从急诊转向了初级保健。俄亥俄州脑震荡法颁布前后，SRC和NSRC可能有不同的医疗保健利用模式。我们的结果表明，俄亥俄州的青少年脑震荡法对医疗保健利用产生了可量化的影响。
