Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},
pubstate = {published},
tppubtype = {article}
}
Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E
Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article
In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.
Abstract | Links | BibTeX | Tags: alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption
@article{Moran2015,
title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},
author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},
doi = {10.14423/SMJ.0000000000000340},
year = {2015},
date = {2015-01-01},
journal = {Southern Medical Journal},
volume = {108},
number = {9},
pages = {553--558},
abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},
keywords = {alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E
Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article
In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.
@article{Moran2015,
title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},
author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},
doi = {10.14423/SMJ.0000000000000340},
year = {2015},
date = {2015-01-01},
journal = {Southern Medical Journal},
volume = {108},
number = {9},
pages = {553--558},
abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Arbogast, K B; Curry, A E; Pfeiffer, M R; Zonfrillo, M R; Haarbauer-Krupa, J; Breiding, M J; Coronado, V G; Master, C L
Point of health care entry for youth with concussion within a large pediatric care network Journal Article
In: JAMA Pediatr, vol. 170, no. 7, 2016.
Abstract | Links | BibTeX | Tags: Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race
@article{Arbogast2016,
title = {Point of health care entry for youth with concussion within a large pediatric care network},
author = {Arbogast, K B and Curry, A E and Pfeiffer, M R and Zonfrillo, M R and Haarbauer-Krupa, J and Breiding, M J and Coronado, V G and Master, C L},
doi = {10.1001/jamapediatrics.2016.0294},
year = {2016},
date = {2016-01-01},
journal = {JAMA Pediatr},
volume = {170},
number = {7},
abstract = {Importance: Previous epidemiologic research on concussions has primarily been limited to patient populations presenting to sport concussion clinics or to emergency departments (EDs) and to those high school age or older. By examining concussion visits across an entire pediatric health care network, a better estimate of the scope of the problem can be obtained. Objective: To comprehensively describe point of entry for children with concussion, overall and by relevant factors including age, sex, race/ethnicity, and payor, to quantify where children initially seek care for this injury. Design, setting, and participants: In this descriptive epidemiologic study, datawere collected from primary care, specialty care, ED, urgent care, and inpatient settings. The initial concussion-related visit was selected and variation in the initial health care location (primary care, specialty care, ED, or hospital) was examined in relation to relevant variables. All patients aged 0 to 17 years who received their primary care from The Children's Hospital of Philadelphia's (CHOP) network and had 1 or more in-person clinical visits for concussion in the CHOP unified electronic health record (EHR) system (July 1, 2010, to June 30, 2014) were selected. Main outcomes and measures: Frequency of initial concussion visits at each type of health care location. Concussion visits in the EHR were defined based on International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes indicative of concussion. Results: A total of 8083 patients were included (median age, 13 years; interquartile range, 10-15 years). Overall, 81.9% (95% CI, 81.1%-82.8%; n = 6624) had their first visit at CHOP within primary care, 5.2%(95% CI, 4.7%-5.7%; n = 418) within specialty care, and 11.7%(95% CI, 11.0%-12.4%; n = 947) within the ED. Health care entry varied by age: 52%(191/368) of children aged 0 to 4 years entered CHOP via the ED, whereas more than three-quarters of those aged 5 to 17 years entered via primary care (5-11 years: 1995/2492; 12-14 years: 2415/2820; and 15-17 years: 2056/2403). Insurance status also influenced the pattern of health care use, with more Medicaid patients using the ED for concussion care (478/1290 Medicaid patients [37%] used the ED vs 435/6652 private patients [7%] and 34/141 self-pay patients [24%]). Conclusions and relevance: The findings suggest estimates of concussion incidence based solely on ED visits underestimate the burden of injury, highlight the importance of the primary care setting in concussion care management, and demonstrate the potential for EHR systems to advance research in this area. Copyright © 2016 American Medical Association. All rights reserved.},
keywords = {Adolescent, Article, Child, childhood disease, Concussion, descriptive research, electronic health record, ethnicity, Female, Health Care, health care utilization, help seeking behavior, hospital patient, human, ICD-9-CM, juvenile, major clinical study, Male, medicaid, pediatric hospital, pediatrics, PENNSYLVANIA, point of health care entry, primary medical care, priority journal, race},
pubstate = {published},
tppubtype = {article}
}
Moran, B; Tadikonda, P; Sneed, K B; Hummel, M; Guiteau, S; Coris, E E
Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians Journal Article
In: Southern Medical Journal, vol. 108, no. 9, pp. 553–558, 2015.
Abstract | Links | BibTeX | Tags: alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption
@article{Moran2015,
title = {Postconcussive Syndrome Following Sports-related Concussion: A Treatment Overview for Primary Care Physicians},
author = {Moran, B and Tadikonda, P and Sneed, K B and Hummel, M and Guiteau, S and Coris, E E},
doi = {10.14423/SMJ.0000000000000340},
year = {2015},
date = {2015-01-01},
journal = {Southern Medical Journal},
volume = {108},
number = {9},
pages = {553--558},
abstract = {Postconcussive syndrome is an increasingly recognized outcome of sports-related concussion (SRC), characterized by a constellation of poorly defined symptoms. Treatment of PCS is significantly different from that of SRC alone. Primary care physicians often are the first to evaluate these patients, but some are unfamiliar with the available therapeutic approaches. This review provides an overview of the pathophysiology of SRC and descriptions of both pharmacologic and nonpharmacologic treatment options to allow primary care physicians to provide evidence-based care to patients experiencing postconcussive syndrome. © 2015 by The Southern Medical Association.},
keywords = {alternative medicine, Amantadine, antidepressant agent, Antidepressive Agents, anxiety disorder, Article, Athletic Injuries, benzodiazepine derivative, beta adrenergic receptor blocking agent, carbamazepine, cognitive therapy, complication, Concussion, dexamphetamine, diet therapy, disease course, disease severity, Dopamine Agents, dopamine receptor stimulating agent, evidence based medicine, exercise, general practitioner, human, Humans, lamotrigine, Major Depression, METHYLPHENIDATE, monoamine oxidase inhibitor, NEUROCHEMISTRY, neuropsychological test, Pathophysiology, pharmacologic therapy, Physicians, Post-Concussion Syndrome, postconcussion syndrome, Postconcussive syndrome, Primary Care, Primary Health Care, primary medical care, rehabilitation care, rehabilitative therapy, return to sport, sport injury, sports related concussion, symptom, traumatic brain injury, tricyclic antidepressant agent, Vestibular rehabilitation, work resumption},
pubstate = {published},
tppubtype = {article}
}