Abstract
BackgroundIncreasing athletic trainer (AT) services in high schools has attracted widespread interest across the nation as an effective instrument to manage injuries and improve children’s health, but there is a lack of evidence on potential medical savings. Our study aimed to address this knowledge gap and provide evidence of AT impacts on medical payments and utilizations to inform public policy decision.MethodsWe obtained medical claims of patients aged 14 to 18 years from the 2011–2014 Oregon All Payer All Claims limited dataset. We calculated payer payments and utilizations for medical claims under AT’s scope of practice. We used zip codes to link patients with the enrollment boundaries of Oregon public high schools, which were classified as either “AT group” or “non-AT group”. We implemented an innovative microsimulation analysis to address the uncertainty of linkage between children and schools.ResultsOur analysis included 64,115 and 84,968 eligible children with Medicaid and commercial insurance, respectively. Associated with high school AT services, Medicaid saved an average of $64 per patient during the study period, while commercial insurance payment rarely changed. AT services may reduce emergency visits for both insurance types but increase total visits for commercially insured patients.ConclusionsOur study provides evidence for the differential impacts of AT services on medical payments and utilizations. The legislators should consider to allocate funds for high schools to directly employ ATs. This will encourage ATs to work to their highest ability to improve children’s wellbeing while containing avoidable medical cost.
Highlights
Increasing athletic trainer (AT) services in high schools has attracted widespread interest across the nation as an effective instrument to manage injuries and improve children’s health, but there is a lack of evidence on potential medical savings
Operated by the Oregon Health Authority, the APAC include administrative healthcare data for Oregonians who are insured through commercial insurance, Medicaid, and Medicare (Oregon All Payer All Claims Database n.d.)
We described characteristics including age, gender, race, ethnicity, and rurality of zip codes based on the Rural-Urban Commuting Area (RUCA) criteria (University of Washington n.d.)
Summary
Increasing athletic trainer (AT) services in high schools has attracted widespread interest across the nation as an effective instrument to manage injuries and improve children’s health, but there is a lack of evidence on potential medical savings. (2019) 6:15 the National Federation of State High School Associations (n.d.), and the Appropriate Medical Care for Secondary School-Aged Athletes Task Force (Almquist et al 2008) recommend that an AT be available to provide medical care for secondary school-aged athletes. While these recommendations are based on “ensuring that young athletes receive consistent and adequate medical care while participating in practices and games” (Almquist et al 2008), they do not consider the cost of providing AT services. It is not surprising that national estimates reveal that only 70% of high schools provide some level of AT services (ranging from a set number of hours per sport season to full-time), and that access to ATs varies greatly across states (Pryor et al 2015)
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