Rural-urban disparities in health care costs and health service utilization following pediatric mild traumatic brain injury.

Abstract

To compare health care costs and service utilization associated with mild traumatic brain injury (mTBI) in rural and urban commercially insured children. MarketScan Commercial Claims and Encounters Data, 2007-2011. We compared health care costs and outpatient encounters for physical/occupational therapy, speech therapy, and psychiatry/psychology encounters 180days after mTBI among rural versus urban children (<18years). A total of 387846 children had mTBI, with 13 percent residing in rural areas. Adjusted mean total health care costs in the 180days after mTBI were $2778 (95% CI: 2660-2897) among rural children, compared to $2499 (95% CI: 2471-2528) among urban children (adjusted cost ratio 1.11, 95% CI 1.06-1.16). Rural-urban differences in utilization for specific services were also found. Total health care costs were higher for rural compared to urban children despite lower utilization of certain services. Differences in health service utilization may exacerbate geographic disparities in adverse outcomes associated with mTBI.