Researchers from Children’s Hospital of Philadelphia (CHOP) found disparities in the completion of follow-up concussion care, particularly among pediatric patients who are publicly insured and identify as Black, suggesting barriers to care exist. The findings, recently published in the Journal of Head Trauma Rehabilitation, will help inform research funded by a newly awarded grant from the U.S. Centers for Disease Control and Prevention (CDC) aimed at addressing disparities in concussion care across socioeconomic groups.
In this retrospective study, the researchers reviewed medical records of children seen in CHOP primary care clinics to determine whether pediatric concussion patients adhered to providers’ follow-up recommendations and continued care until doctors cleared them to return to full activity. The study evaluated variations in patients’ adherence to follow-up recommendations by analyzing data available in the medical record, including race, ethnicity, insurance, age, sex, how the patients were injured and whether the patient sustained repeat head injuries.
The study found that out of 755 total patients, non-Hispanic black patients and publicly insured or self-paying patients were less likely to complete follow-up recommendations (70.6% for both of those groups) compared with non-Hispanic White patients and privately insured patients (83.5% and 82.9%, respectively). After adjusting for age, sex, injury mechanism, and repeated injuries, non-Hispanic black patients were more than 50% less likely to complete follow-up care recommendations and publicly insured patients were 40% less likely to do so compared to their non-Hispanic white and privately insured peers, respectively.
