Failure to Receive Specialty Concussion Care in Pediatric Patients
Jonathan Davidow1, Anmol Singh2, Henry Neri3, Paige Buddenhagen4, Kate Essad4
1Medical College of Wisconsin, 2American University of the Caribbean SOM, 3Marquette University, 4Aurora Health
Objective:
To identify and present risk factors for failure to follow-up with specialized concussion management in the pediatric population.
Background:
Analysis of subgroups with specific medical management needs, such as the pediatric population, provides important insights regarding the care of at-risk populations. We seek to add to the literature offering fuller understanding of the factors associated with modifiable differences in concussion management.
Design/Methods:
Using retrospective chart review from a dedicated work queue in the electronic medical record, analysis of 414 pediatric patients referred to the specialty concussion program at a large health system from 2019 through 2022 is underway.
Results:

Preliminary data indicates that more than 50% of patients were female, more than 50% of patients were between 15 and 17 years old. Fewer than 43% of patients receive the recommended evaluation and treatment. Risk factors for not accepting an appointment include living in a rural suburb and being referred from emergency services. Patients referred for specialty care who do not live geographically near a neurologist are more likely to accept specialty care.

Conclusions:

Our data suggests that the pediatric population mirrors certain socioeconomic disparities seen in literature and in the adult population in this concussion management network. Analysis implies that adherence to treatment for sport-related concussion and other mechanisms of injury follows stated socioeconomic and geographic lines. The high rate of compliance for very rural populations suggests that these populations would likely benefit from opportunities for more immediate care to prevent sequelae.

There are opportunities to further reach special populations who would expressly benefit from early and consistent specialized concussion care. Ongoing research should emphasize the inequities in specialized neurological care and identify opportunities to provide excellent care to all children.

10.1212/WNL.0000000000203569