Referral Patterns for Pediatric Sports-Related Concussion in One New England Health Care System

Journal of Maine Medical Center Pub Date : 2023-08-10 DOI:10.46804/2641-2225.1154

Joseph Benert, Amy E. Haskins, C. Holt, Krystian Bigosinski

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Abstract

Introduction: Patients with concussion may benefit from care provided by professionals from multiple disciplines based on the constellation of symptoms being reported. This study analyzed referral patterns from primary care and sports medicine clinicians for pediatric patients with sports-related concussion in one health care system. Methods: A retrospective chart review identified referrals placed to physical therapy, occupational therapy, speech pathology, optometry, psychology, neuropsychology, audiology, neurology, ophthalmology, otolaryngology, psychiatry, and sports medicine for pediatric patients with sports-related concussion. These patients were evaluated at MaineHealth family medicine, internal medicine/pediatrics, pediatrics, and sports medicine clinics in southern Maine between February 2019 and June 2022. Results: We identified 375 patients with concussions. These patients were most often evaluated by pediatrics (199; 53.1%) and sports medicine (160; 42.7%), with fewer evaluated by family medicine (28; 7.5%), internal medicine/pediatrics (8 patients; 2.1%), or internal medicine (6; 1.6%). The most common referrals were to physical therapy (40; 10.7%), sports medicine (21; 5.6%), psychology (11; 2.9%), and neurology (9; 2.4%). Sports medicine placed a significantly higher number of referrals ( P < .0001) than non-sports medicine disciplines. Discussion: Compared to prior research, fewer referrals were placed in this cohort of patients with concussion. Possible explanations include a larger population of uncomplicated concussions, the more rural setting in which this study occurred, or a lack of awareness of resources for further concussion care. Conclusions:

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新英格兰医疗系统中儿童运动相关脑震荡的转诊模式

引言：脑震荡患者可能会根据报告的症状群，从多个学科的专业人员提供的护理中受益。本研究分析了初级保健和运动医学临床医生在一个医疗保健系统中对运动相关脑震荡儿童患者的转诊模式。方法：一项回顾性图表审查确定了接受物理治疗、职业治疗、言语病理学、验光、心理学、神经心理学、听力学、神经病学、眼科、耳鼻喉科、精神病学和运动医学的转诊儿童运动相关脑震荡患者。2019年2月至2022年6月，这些患者在缅因州南部的MaineHealth家庭医学、内科/儿科、儿科和运动医学诊所接受了评估。结果：我们确定了375名脑震荡患者。这些患者最常通过儿科（199；53.1%）和运动医学（160；42.7%）进行评估，较少通过家庭医学（28；7.5%）、内科/儿科（8名患者；2.1%）或内科（6；1.6%）进行评估。最常见的转诊是物理治疗（40；10.7%）、运动医学（21；5.6%）、心理学（11；2.9%），和神经病学（9；2.4%）。运动医学的转诊人数明显高于非运动医学学科（P<.0001）。讨论：与先前的研究相比，这一脑震荡患者队列中的转诊人数较少。可能的解释包括更多的无并发症脑震荡人群，这项研究发生在更偏远的农村地区，或者缺乏对进一步脑震荡护理资源的认识。结论：

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of Maine Medical Center

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