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Rural‐urban disparities in health care costs and health service utilization following pediatric mild traumatic brain injury
Author(s) -
Graves Janessa M.,
Mackelprang Jessica L.,
Moore Megan,
Abshire Demetrius A.,
Rivara Frederick P.,
Jimenez Nathalia,
Fuentes Molly,
Vavilala Monica S.
Publication year - 2019
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.13096
Subject(s) - medicine , traumatic brain injury , health care , rural area , occupational safety and health , environmental health , poison control , injury prevention , suicide prevention , psychiatry , pathology , economics , economic growth
Objectives To compare health care costs and service utilization associated with mild traumatic brain injury ( mTBI ) in rural and urban commercially insured children. Data Source MarketScan Commercial Claims and Encounters Data, 2007‐2011. Study Design We compared health care costs and outpatient encounters for physical/occupational therapy, speech therapy, and psychiatry/psychology encounters 180 days after mTBI among rural versus urban children (<18 years). Principal Findings A total of 387 846 children had mTBI , with 13 percent residing in rural areas. Adjusted mean total health care costs in the 180 days after mTBI were $2778 (95% CI : 2660‐2897) among rural children, compared to $2499 (95% CI : 2471‐2528) among urban children (adjusted cost ratio 1.11, 95% CI 1.06‐1.16). Rural‐urban differences in utilization for specific services were also found. Conclusions Total health care costs were higher for rural compared to urban children despite lower utilization of certain services. Differences in health service utilization may exacerbate geographic disparities in adverse outcomes associated with mTBI .