Pediatric Concussion Health Service Utilization and Follow-Up Care: A Population-Based Epidemiological Study Using Administrative Health Data

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dc.contributor.advisorZwicker, Jennifer
dc.contributor.advisorYeates, Keith
dc.contributor.authorWittevrongel, Krystle
dc.contributor.committeememberSchneider, Kathryn
dc.contributor.committeememberHagel, Brent
dc.date2021-11
dc.date.accessioned2021-08-23T17:57:07Z
dc.date.available2021-08-23T17:57:07Z
dc.date.issued2021-08-19
dc.description.abstractConcussion is a common injury among children and youth, although population-level incidence and trends related to service use are not well described in the literature. In addition, while treatment and management decisions are led by best practices and clinical guidelines, there is a paucity of studies exploring the individual and contextual factors that impact health service utilization following concussion in the pediatric patient. Thus, the objective of this thesis was to address these gaps and better understand how children and youth are interacting with the health care system following concussion in Alberta. In this thesis, 14-years of system-level linked administrative health data and a defined episode of care (EOC) were used to describe trends in health care utilization following pediatric concussion in Alberta. An increased incidence of concussion and other mild head injury diagnoses was observed across the province. In addition, a shift in care from emergency department (ED) to outpatient physician office (PO) settings and a higher use of the ED by some segments of the population was observed. Findings suggest some children and youth are more likely to receive care following a concussion. In addition, follow-up care increased over time, demonstrating accordance with clinical guidelines. However, rates remained low, indicating a lack of application by provider or adherence by patient. Findings indicate that the likelihood of receiving follow-up care in Alberta was influenced by both individual and contextual factors. Factors related to need (perceived and evaluated) were most strongly associated with health care utilization. The index visit occurring in PO had the strongest positive association with follow-up care, followed by a history of concussion-related EOC. At the same time, patient predisposing and enabling factors also affected utilization. Younger children and youth, females, and those from areas of lower socioeconomic status (SES) or residing in certain geographical areas were less likely to receive follow-up care. Findings suggest that to improve service delivery and targeted treatment in line with clinical guidelines for all children and youth, policies that focus on equitable access are needed.en_US
dc.identifier.citationWittevrongel, K. (2021). Pediatric concussion health service utilization and follow-up care: a population-based epidemiological study using administrative health data (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca.en_US
dc.identifier.doihttp://dx.doi.org/10.11575/PRISM/39116
dc.identifier.urihttp://hdl.handle.net/1880/113760
dc.language.isoengen_US
dc.publisher.facultyKinesiologyen_US
dc.publisher.institutionUniversity of Calgaryen
dc.rightsUniversity of Calgary graduate students retain copyright ownership and moral rights for their thesis. You may use this material in any way that is permitted by the Copyright Act or through licensing that has been assigned to the document. For uses that are not allowable under copyright legislation or licensing, you are required to seek permission.en_US
dc.subjectconcussionen_US
dc.subjectpediatricen_US
dc.subjectadministrative health dataen_US
dc.subjectclinical guidelinesen_US
dc.subjecthealth service utilizationen_US
dc.subjecthealth systemen_US
dc.subject.classificationEducation--Healthen_US
dc.subject.classificationHealth Care Managementen_US
dc.subject.classificationPublic Healthen_US
dc.titlePediatric Concussion Health Service Utilization and Follow-Up Care: A Population-Based Epidemiological Study Using Administrative Health Dataen_US
dc.typemaster thesisen_US
thesis.degree.disciplineKinesiologyen_US
thesis.degree.grantorUniversity of Calgaryen_US
thesis.degree.nameMaster of Science (MSc)en_US
ucalgary.item.requestcopytrueen_US
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