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Ramsay, Scott James

University of British Columbia

Concussions are a major health issue for children and youth, with negative physical and mental health outcomes, some of which have long-lasting effects. Given the high incidence and burden of concussion, timely follow-up and management of concussion is crucial. After a concussion diagnosis, follow-up visits with a health care provider are important for reassessment, continued management, and further education. The factors that influence the timeliness of the first follow-up visit post diagnosis are not well understood, nor is the relationship between timing of the follow-up visit and the length and severity of symptoms experienced. Therefore, in this dissertation I addressed three research objectives: 1) to explore the rates and timing of a first follow-up visit for children and youth with a concussive injury; 2) to identify factors associated with follow-up timing; and 3) to investigate the effect of timing of the first follow-up visit on children's health after a concussion. This descriptive, correlational study drew on linked, population-based administrative data from the province of British Columbia, Canada, resulting in a sample of 22,601 pediatric concussion cases. The main measure in the study was timing of the first follow-up visit, which was measured as timely (within 28 days post-concussion diagnosis), delayed (29 days to 3 months), and no follow-up. Other study measures included age, sex, geographic residence, socioeconomic status, and type of health care provider at the index visit. Binary and multinomial logistic regression were the main analytic strategies used. Findings showed low levels of timely follow-up. Older age, living in a rural area, higher socioeconomic status, and seeing a specialist physician at an initial concussion diagnosis were associated with a timely follow-up visit. Lastly, children and youth with a delayed follow-up visit were more likely to experience a residual health outcome within 12 months of an initial diagnosis compared to those with timely follow-up. This study is one of the first Canadian population-based explorations into the timing of follow-up visits of concussed children and youth, and provides evidence supporting the importance of a timely first follow-up visit after a concussion diagnosis as a pivotal part of pediatric concussion management.

Text

2024-09-30

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/85554

Nursing

University of British Columbia

UBCV

http://creativecommons.org/licenses/by-nc-nd/4.0/