Health care utilization for concussion among children has increased significantly, partly because of increased awareness but also because of the introduction of health care legislation mandating medical intervention before return to play, new data suggest.
Analysis of health insurance claims for insured children aged 12-18 years from the MarketScan database showed a 92% increase in concussion-related health care utilization between 2008-2009 and 2011-2012 in states with concussion legislation, compared with a 75% overall increase in states without the legislation, according Teresa B. Gibson, Ph.D., of the department of health care policy at Harvard Medical School, Boston, and her colleagues (JAMA Pediatrics 2014 Dec. 22 [doi:10.1001/jamapediatrics.2014.2320]).
After 2009, when the first state concussion laws were passed, states without those laws still demonstrated a 20.9% annual increase in health care utilization for concussion, while states with those laws showed, on average, an additional 13.1% increase, they noted.
At the end of the 2011-2012 school year, 35 states (70%) plus the District of Columbia had laws about sports-related concussion in children.
“We estimate that slightly more than half (60%) the increase in states without laws in effect resulted from the continued trend of increasing health care utilization established before the first law was passed,” the investigators wrote. Although the sources leading to the remaining 40% increase in utilization were not studied, it is likely that increased awareness of concussion brought by local and national media attention played a role.
The study was partly supported by Truven Health from the National Institute of Child Health and Human Development. No other conflicts of interest were declared.