Utilization of Mental Health Services After Mild Pediatric Traumatic Brain Injury

Jimenez, Nathalia; Quistberg, Alex; Vavilala, Monica S.; Jaffe, Kenneth M.; Rivara, Frederick P.

doi:10.1542/peds.2016-2462

Cited by 23 publications

(14 citation statements)

References 24 publications

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“…Indeed, previous mental health disorder has been associated with post-TBI mental health service utilization for children with mild traumatic brain injury. 36 The differential mental health service utilization by race/ethnicity noted in the present study may in part explain previously noted racial disparities in outcomes for children after TBI. 22, 23,29,30 …”

Section: Discussionsupporting

confidence: 48%

Racial Disparities in Outpatient Mental Health Service Use Among Children Hospitalized for Traumatic Brain Injury

Moore¹,

Jimenez²,

Graves³

et al. 2018

Journal of Head Trauma Rehabilitation

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Objective To examine racial differences in mental health service utilization after hospitalization for traumatic brain injury (TBI) among children with Medicaid insurance. Design and Main Measures Retrospective analysis of the MarketScan® Multi-State Medicaid database from 2007-2012 was performed. Outpatient mental health service utilization (psychiatric and psychological individual and group services) was compared at TBI hospitalization, from discharge to 3 months and from 4 to 12 months after discharge between children of non-Hispanic White (NHW), non-Hispanic Black (NHB), Hispanic and “Other” racial groups. Multivariable mixed effects Poisson regression models with robust standard errors were utilized. Results 5,674 children (<21 years) were included in the study. There were no differences by race/ethnicity in mental health service utilization during hospitalization. At 3 months post discharge, NHB children and children in the “Other” racial category were significantly less likely to receive outpatient mental health services compared to NHW children (NHB RR=0.84; 95%CI:0.72-0.98; Other RR=0.72; 95%CI:0.57-0.90). At 12 months, all racial minority children were significantly less likely to receive outpatient mental health services compared to NHW children (NHB RR=0.84, 95%CI:0.75-0.94; Hispanic RR=0.72, 95%CI:0.55-0.94; Other RR=0.71, 95%CI:0.60-0.84). Conclusion Racial disparities in utilization of outpatient mental health services exist for minority children hospitalized for TBI and insured by Medicaid. Future research should focus on improving transitions of care from inpatient to outpatient services for these children.

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Section: Discussionsupporting

confidence: 48%

Racial Disparities in Outpatient Mental Health Service Use Among Children Hospitalized for Traumatic Brain Injury

Moore¹,

Jimenez²,

Graves³

et al. 2018

Journal of Head Trauma Rehabilitation

Self Cite

View full text Add to dashboard Cite

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“…Flow diagram of cohort recruitment. Child and family characteristics Enrollment site Texas (versus Utah), n (%) 50 ( 42) 44 ( 40) 52 (44) .82 Prefer to complete surveys online, n (%) 82 ( 69) 93 ( 85) 90 (76) .02 Preferred language Spanish (versus English), n (%) 14 ( 12) 4 ( 4) 15 (13) .04 Age at injury, y, mean (SD) 10.3 (3.7) 10.5 (3.5) 9.7 (3.7) .16 Child sex female, n (%) 44 ( 37) 33 ( 30) 44 (37) .43 Child race, n (%) .14 American Indian or Alaskan native 2 (2) 0 (0) 0 (0) Asian American 1 (1) 5 ( 5) 2 (2) African American 11 ( 9) 4 ( 4 Injury mechanism differed, with the youngest age group sustaining the mildest injuries, primarily from falls. Loss of consciousness was reported in 11% of younger and 33% to 41% of older children.…”

Section: Figurementioning

confidence: 99%

Persistent Postconcussion Symptoms After Injury

et al. 2018

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We examined whether preinjury, demographic, and family factors influenced vulnerability to postconcussion symptoms (PCSs) persisting the year after mild traumatic brain injury (mTBI). METHODS:Children with mTBI (n = 119), complicated mild traumatic brain injury (cmTBI) (n = 110), or orthopedic injury (OI) (n = 118), recruited from emergency departments, were enrolled in a prospective, longitudinal cohort study. Caregivers completed retrospective surveys to characterize preinjury demographic, child, and family characteristics. PCSs were assessed using a validated rating scale. With multivariable general linear models adjusted for preinjury symptoms, we examined predictors of PCSs 3, 6, and 12 months after injury in children ages 4 to 8, 9 to 12, and 13 to 15 years at injury. With logistic regression, we examined predictors of chronic PCSs 1 year after traumatic brain injury.RESULTS: Postinjury somatic, emotional, cognitive, and fatigue PCSs were similar in the mTBI and cmTBI groups and significantly elevated compared with the OI group. PCS trajectories varied with age and sex. Adolescents had elevated PCSs that improved; young children had lower initial symptoms and less change. Despite similar preinjury PCSs, girls had elevated symptoms across all time points compared with boys. PCS vulnerability factors included female sex, adolescence, preinjury mood problems, lower income, and family discord. Social capital was a protective factor. PCSs persisted in 25% to 31% of the traumatic brain injury group and 18% of the OI group at 1 year postinjury. The odds of chronic PCSs were almost twice as high in girls as in boys and were >4 times higher in young children with cmTBI than in those with mTBI. CONCLUSIONS:A significant minority of children with mTBI and OI have PCSs that persisted 1 year after injury.

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“…The Truven Health MarketScan® Claims and Encounter Database (Truven Health Analytics, IBM Watson Health™, Ann Arbor, MI, USA) contains insurance claims data 16 . For this project, modules containing data from both commercial insurers and Medicaid programs were used, as described in previously published studies 17–22 . This database provides in‐depth, cross‐sectional, and longitudinal patient‐level data.…”

Section: Methodsmentioning

confidence: 99%

“…16 For this project, modules containing data from both commercial insurers and Medicaid programs were used, as described in previously published studies. [17][18][19][20][21][22] This database provides in-depth, cross-sectional, and longitudinal patient-level data. It is a large convenience sample that is geographically representative of the population within the United States, spanning the entire nation.…”

Section: Data Sourcementioning

confidence: 99%

Variation in the use of pulmonary vasodilators in children and adolescents with pulmonary hypertension: a study using data from the MarketScan® insurance claims database

et al. 2020

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Utilization of Mental Health Services After Mild Pediatric Traumatic Brain Injury

Cited by 23 publications

References 24 publications

Racial Disparities in Outpatient Mental Health Service Use Among Children Hospitalized for Traumatic Brain Injury

Racial Disparities in Outpatient Mental Health Service Use Among Children Hospitalized for Traumatic Brain Injury

Persistent Postconcussion Symptoms After Injury

Variation in the use of pulmonary vasodilators in children and adolescents with pulmonary hypertension: a study using data from the MarketScan® insurance claims database

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