31 May Pediatric Concussions Underestimated as Primary Care Presentations Not Reported
MedicalResearch.com Interview with:
Kristy Arbogast, PhD
Center for Injury Research and Prevention
The Children’s Hospital of Philadelphia
Division of Emergency Medicine
Department of Pediatrics
University of Pennsylvania
Philadelphia, PA 19104
MedicalResearch.com: What is the background for this study? What are the main findings?
Dr. Arbogast: The research team looked retrospectively at four recent years of data on children diagnosed with concussion at Children’s Hospital of Philadelphia (CHOP) to determine how children access the health system for a concussion. For those 8,000 kids with a CHOP primary care provider, 82% entered the health system via a primary care location, 12% entered through the ER and 5% through a specialist. One-third of concussion diagnoses were to children under age 12.
Many current counts of concussion injury among children are based on emergency room visits or organized high school and college athletics data. Thus, we are vastly underestimating child and youth concussions in the US.
MedicalResearch.com: What should readers take away from your report?
Dr. Arbogast: Parents should be informed, ask questions, and treat any suspected concussion as a brain injury and seek care early. Their child’s primary care provider may be the most efficient place to start care as typically, compared to more specialized settings, a primary care practice can see injured patients sooner, thus getting them on the proper path for treatment earlier. Key to recovery from a concussion is early diagnosis and treatment—including early cognitive and physical rest—followed by a supervised return to learning and activity. The majority of concussions will resolve with this approach in two to three weeks. Patients with lingering symptoms or other comorbidities can be referred for specialist care.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Arbogast: This study provides direction for health system networks and clinicians about where targeted training and resources need to be deployed. Ensuring that primary care pediatricians and family practice clinicians have contemporary training in pediatric-specific concussion management best practices is critical. Secondly, this study will also inform future concussion surveillance systems on how to more accurately track the number of youth concussions in the US. Better estimates of the number, causes, and outcomes of concussion will allow us to more effectively prevent and treat concussions sustained by children.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Arbogast: The use of the primary care setting as the point of entry for healthcare for concussion is in alignment with value-based care – right care to right person at the right time – that is being encouraged by the Affordable Care Act and other advances in healthcare utilization in the US.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Kristy B. Arbogast et al. Point of Health Care Entry for Youth With Concussion Within a Large Pediatric Care Network. JAMA Pediatrics, 2016 DOI:10.1001/jamapediatrics.2016.0294
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