Association Between Follow-Up Visit Timing After A Concussion and Subsequent Care Seeking in Children and Youth: A Population-Based Study in British Columbia.

Abstract

To assess the relationship between follow-up visit timing and occurrence of the first subsequent health care seeking visit. The province of British Columbia, Canada. A total of 21029 children and youth who were diagnosed with an initial concussion from January 1, 2016, to December 31, 2017. These data were obtained from Population Data BC. A retrospective, descriptive correlational study. Follow-up timing was measured categorically as timely (4weeks), delayed (1-3months), or no follow-up; the occurrence of a subsequent health care visit beyond 3months postinjury was measured up to 12months at 3-month intervals (ie, 4-6, 7-9, and 10-12months). These variables were measured using diagnostic codes for concussion, post-concussion syndrome, and the 17 concussion symptoms. After controlling for sociodemographic characteristics, having a delayed follow-up, relative to timely follow-up, was associated with higher odds of a subsequent health care seeking visit at 4 to 6months (odds ratio [OR]=2.68; confidence interval [CI], 2.08-3.47), 7 to 9months (OR=1.71; CI, 1.21-2.40), and 10 to 12months (OR=1.67; CI, 1.13-2.48). In contrast to having a delayed follow-up, having no follow-up, relative to timely follow-up, was associated with not having a subsequent health care seeking visit at 4 to 6months (OR=0.57; CI, 0.48-0.67) and 7 to 9months (OR=0.79; CI, 0.66-0.96), respectively. Follow-up visit timing after a concussion in children and youth is associated with subsequent health care seeking. Greater efforts are needed to investigate the importance of initial follow-up visit timing, as they may play an integral role in injury prevention and symptom management following injury.