TY  - JOUR
PY  - 2019//
TI  - Initial emergency department visit and follow-up care for concussions among children with Medicaid
JO  - Journal of pediatrics
A1  - Tarimala, Anirudh
A1  - Singichetti, Bhavna
A1  - Yi, Honggang
A1  - Huang, Lihong
A1  - Doerschuk, Rachel
A1  - Tiso, Michael
A1  - Yang, Jingzhen
SP  - 178
EP  - 183
VL  - 206
IS  - 
N2  - OBJECTIVE: To describe the rates and patterns of initial emergency department (ED) encounters and follow-up care for concussions among Medicaid-insured children before and after the 2013 enactment of Ohio concussion law. STUDY DESIGN: Using a time-series design, this study analyzed concussion claim data obtained from Partners for Kids, a pediatric accountable-care organization in Ohio. A total of 12 512 concussions and 48 238 associated claims for services between January 1, 2008, and June 30, 2017, with an initial ED encounter among Medicaid-insured children (ages 0-18 years) were analyzed. The effect of the law on the odds of follow-up care were assessed using generalized estimating equations models, adjusted for sex, age group, and residence location. <br><br>RESULTS: Of the total 12 512 concussions, 63.9% occurred in male patients, 70.1% in patients ages 10-18 years, and 65.2% in patients from urban areas. The rate of initial ED encounters for concussions increased from 2008 to 2014 (2.8 to 4.9 per 10 000 members), followed by a decrease in 2016 (4.2 per 10 000 members). A significant increase in follow-up care after the initial ED encounter was observed from pre-law to post-law (OR 1.73, 95% CI 1.61, 1.86). A shift in follow-up care was observed from radiology and ambulance services in pre-law to primary care providers in post-law. <br><br>CONCLUSIONS: The Ohio concussion law may have influenced the patterns of initial ED visit and follow-up care for concussions among Medicaid-insured children. Future studies evaluating the impact of the law should analyze the utilization patterns among children with various insurance/payment types.<br><br>Copyright © 2018 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-3476
UR  - http://dx.doi.org/10.1016/j.jpeds.2018.10.021
ID  - ref1
ER  -