{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T09:54:14Z","timestamp":1765619654181,"version":"3.40.5"},"reference-count":36,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T00:00:00Z","timestamp":1671494400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can. J. Neurol. Sci."],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>ABSTRACT:<\/jats:title><jats:sec id=\"S0317167122003468_as1\"><jats:title>Background:<\/jats:title><jats:p>Concussion affects 1.2% of the population annually; rural regions and children have higher rates of concussion.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167122003468_as2\"><jats:title>Methods:<\/jats:title><jats:p>Using administrative health care linked databases, all residents of Ontario with a physician diagnosed concussion were identified using ICD-9 code 850 or ICD-10 code S06. Cases were tracked for 2 years for concussion-related health care utilization with relevant specialist physicians (i.e., neurology, otolaryngology, physiatry, psychiatry, ophthalmology). Billing codes, specialist codes, and time from index to visit were analyzed. Factors associated with increased specialist visits were also examined.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167122003468_as3\"><jats:title>Results:<\/jats:title><jats:p>In total, 1,022,588 cases were identified between 2008 and 2014 with 2 years of post-concussion health care utilization available. Follow-up by physician within 3 days of injury occurred in only 14% of cases. Mean time between ED diagnosis and follow-up by a physician was 83.9 days, whereas for rural regions it was &gt;100 days. About half of adults (51.9%) and children (50.3%) had at least 1 specialist visit following concussion. Mean time between injury and first specialist visit was 203.8 (SD 192.9) days for adults, 213.5 (SD 201.0) days for rural adults, and 276.0 (SD 202.6) days for children. There were 67,420 neurology visits, 70,404 psychiatry visits, 13,571 neurosurgery visits, 19,780 physiatry visits, 101,788 ENT visits, and 103,417 ophthalmology visits in the 2 years tracking period. Factors associated with more specialist use included age &gt; 18 years, urban residence, and pre-injury psychiatric history.<\/jats:p><\/jats:sec><jats:sec id=\"S0317167122003468_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>There are discrepancies in post-concussion health care utilization based on age group and rural\/urban residence. Addressing these risk factors could improve concussion care access.<\/jats:p><\/jats:sec>","DOI":"10.1017\/cjn.2022.346","type":"journal-article","created":{"date-parts":[[2022,12,20]],"date-time":"2022-12-20T08:15:31Z","timestamp":1671524131000},"page":"87-97","source":"Crossref","is-referenced-by-count":6,"title":["Medical Care Among Individuals with a Concussion in Ontario: A Population-based Study"],"prefix":"10.1017","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4408-355X","authenticated-orcid":false,"given":"Laura Kathleen","family":"Langer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark Thedore","family":"Bayley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charissa","family":"Levy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Elizabeth Patricia","family":"Munce","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1386-7127","authenticated-orcid":false,"given":"David Wyndham","family":"Lawrence","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alan","family":"Tam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire","family":"de Oliveira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2022,12,20]]},"reference":[{"key":"S0317167122003468_ref23","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2016.1217081"},{"volume-title":"Guideline for concussion\/mild traumatic brain injury and prolonged symptoms: 3nd edition (for adults 18+ years of age)","year":"2018","author":"Marshall","key":"S0317167122003468_ref7"},{"volume-title":"Census of Canada","year":"2016","key":"S0317167122003468_ref16"},{"volume-title":"Living guideline for diagnosing and managing pediatric concussion","year":"2019","author":"Reed","key":"S0317167122003468_ref21"},{"key":"S0317167122003468_ref14","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0000000000000399"},{"key":"S0317167122003468_ref3","doi-asserted-by":"publisher","DOI":"10.1080\/02699050410001720158"},{"key":"S0317167122003468_ref24","doi-asserted-by":"publisher","DOI":"10.1080\/026990599121007"},{"key":"S0317167122003468_ref11","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1203"},{"key":"S0317167122003468_ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2016.10.067"},{"key":"S0317167122003468_ref18","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2018.3820"},{"key":"S0317167122003468_ref10","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2014.3600"},{"key":"S0317167122003468_ref34","doi-asserted-by":"publisher","DOI":"10.1017\/S0317167100015584"},{"key":"S0317167122003468_ref13","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.1313"},{"key":"S0317167122003468_ref4","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/19.10.543"},{"key":"S0317167122003468_ref35","doi-asserted-by":"publisher","DOI":"10.1186\/s12909-018-1416-7"},{"key":"S0317167122003468_ref33","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-2492"},{"volume-title":"Surveillance report of traumatic brain injury-related emergency department visits, hospitalizations, and deaths \u2013 United States, 2014","year":"2019","key":"S0317167122003468_ref2"},{"key":"S0317167122003468_ref28","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2296-15-16"},{"key":"S0317167122003468_ref27","doi-asserted-by":"publisher","DOI":"10.1097\/01.MLR.0000053971.89707.97"},{"key":"S0317167122003468_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-12-76"},{"key":"S0317167122003468_ref32","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2015.4381"},{"key":"S0317167122003468_ref36","unstructured":"36. Rowan\u2019s law: concussion awareness resources. Province of Ontario, 2021). accessed 19\/9\/2022. https:\/\/www.ontario.ca\/page\/rowans-law-concussion-awareness-resources,"},{"key":"S0317167122003468_ref19","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092256"},{"key":"S0317167122003468_ref26","first-page":"10","article-title":"Barriers to traumatic brain injury services and supports in rural settings","volume":"80","author":"Solovieva","year":"2014","journal-title":"J Rehabil."},{"key":"S0317167122003468_ref1","first-page":"E60","article-title":"Increasing incidence of concussion: true epidemic or better recognition?","volume":"35","author":"Langer","year":"2020","journal-title":"JHTR"},{"key":"S0317167122003468_ref20","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097415"},{"key":"S0317167122003468_ref6","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2019.4552"},{"key":"S0317167122003468_ref8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1003652"},{"volume-title":"Ontario\u2019s mosaic of children\u2019s treatment services","year":"2005","author":"Dick","key":"S0317167122003468_ref17"},{"key":"S0317167122003468_ref29","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2009.1068"},{"key":"S0317167122003468_ref22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.2002.tb00882.x"},{"key":"S0317167122003468_ref30","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-018-0091-y"},{"key":"S0317167122003468_ref31","doi-asserted-by":"publisher","DOI":"10.1080\/13854046.2018.1508616"},{"key":"S0317167122003468_ref15","first-page":"1","article-title":"Identification of hidden health utilization services and costs in adults awaiting tertiary care following mild traumatic brain injury in Toronto, Ontario, Canada","author":"Hunt","year":"2016","journal-title":"Concussion"},{"key":"S0317167122003468_ref9","doi-asserted-by":"publisher","DOI":"10.1037\/a0027888"},{"key":"S0317167122003468_ref25","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2015.04.016"}],"container-title":["Canadian Journal of Neurological Sciences \/ Journal Canadien des Sciences Neurologiques"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0317167122003468","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T11:02:57Z","timestamp":1710414177000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0317167122003468\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,20]]},"references-count":36,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1]]}},"alternative-id":["S0317167122003468"],"URL":"https:\/\/doi.org\/10.1017\/cjn.2022.346","relation":{},"ISSN":["0317-1671","2057-0155"],"issn-type":[{"type":"print","value":"0317-1671"},{"type":"electronic","value":"2057-0155"}],"subject":[],"published":{"date-parts":[[2022,12,20]]}}}