Article

OBJECTIVE: To compare the healthcare use by children with and without a traumatic
brain injury (TBI) in the year following injury to understand whether children
access primary care. PARTICIPANTS: Children 0 to 15 years with a TBI (N = 545)
and (N = 2310) uninjured age and sex-matched comparisons. SETTING: A full
benefits healthcare plan from 2000 to 2007. MAIN MEASURES: Mean annual healthcare
utilization. RESULTS: Children with TBI had higher mean annual outpatient visits
(4.2 vs. 3.5, P = .001), but similar mean annual general pediatric visits (2.7
vs. 2.8, P = .3) than comparison children. More cases than comparisons attended a
general pediatric visit (80.0% vs. 73.3%, risk ratio = 1.1, 95% CI: 1.0-1.1).
However, approximately 50% of children older than 7 years who had an intracranial
injury did not attend a general pediatric visit and those were slightly more
likely to receive specialty care (adjusted risk ratio = 1.1, 95% CI: 1.0-1.2).
These children did not appear to be substituting specialty for primary care.
CONCLUSIONS: Children with a full benefits insurance plan do not access primary
care routinely after TBI. These findings present a challenge for designing a
system to screen children after TBI.

Langue : ANGLAIS