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Citation
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Marmor WA, McElheny KD, Lingor RJ, Shetty T, Lin E, Casey E, Ling DI. PM R 2022; ePub(ePub): ePub. |
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Abstract
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Background
Health disparities related to concussions have been reported in the literature for certain minority populations. Given the significant impact of concussions on long- and short-term function, the mitigation of barriers to accessing care is an important public health objective.
Objective
To determine if racial and ethnic disparities exist in patients who seek care for concussions compared to a control group with orthopedic ankle injuries (sprains and fractures) to minimize confounding factors that predispose to injury.
Design
Cohort study
Setting
Single institution between February 2016 and December 2020
Patients
A retrospective review of electronic medical records was completed for patients with ICD-10 diagnosis codes for concussion, ankle sprain, and ankle fracture. A total of 10,302 patients were identified: 1,568 (15.2%) with concussion, 4,871 (47.3%) with ankle sprain, and 3,863 (37.5%) with ankle fracture.
Interventions
Patients were stratified by demographic factors, including sex, ethnicity, race, and insurance type.
Main Outcome Measures
Diagnosis of concussion.
Results
The concussion group was the youngest (28.3±18.0) and had the fewest females (53.1%) compared to sprains (35.1±19.7; 58.7%) and fractures (44.1±21.3; 57.3%). The concussion group had a smaller proportion of Hispanic patients than ankle sprains (OR 0.71, 95% CI 0.55-0.92, p=0.010) and fractures (OR 0.58, 95% CI 0.44-0.75, p=<0.001). Additionally, the concussion group was less likely to be Asian (OR 0.70, CI 0.52-0.95, p=0.023) than the sprain group and less likely to be Black/African American than both sprains (OR 0.65, 95% CI 0.46-0.93, p=0.017) and fractures (OR 0.62, 95% CI 0.43-0.89, p=0.010). There were no differences across racial groups between ankle sprains and fractures. Patients with Medicaid/Medicare and self-pay had a higher likelihood of being in the concussion group than those with private insurance.
Conclusions
Differences in concussion diagnosis may exist between certain demographic groups compared to those with ankle injuries. Efforts to mitigate disparities in concussion care are worthwhile with a focus on patient and caregiver education.
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Language: en |