{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T18:26:52Z","timestamp":1759775212269,"version":"3.40.5"},"reference-count":33,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T00:00:00Z","timestamp":1596412800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100005217","name":"National Center for Injury Prevention and Control","doi-asserted-by":"publisher","award":["3 R49 CE002106\u201005S1"],"award-info":[{"award-number":["3 R49 CE002106\u201005S1"]}],"id":[{"id":"10.13039\/100005217","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>The current study examines rural\u2010urban differences in trends in rates and type of concussion\u2010related health care utilization over time from 2008 to 2016 among Medicaid insured children in Ohio.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analyzed Medicaid claims for health care utilization for diagnosed concussions among children aged \u226418 years between April 1, 2008, and December 31, 2016. We compared the trends in rates of concussion\u2010related health care utilization between children who lived in rural and urban areas using Poisson regressions. We examined trends in the type of concussion\u2010related health care utilization by location of residence using linear regressions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>We found a significant increase in health care utilization for concussion over time, with rates of treated concussion consistently higher in rural children compared to urban children (<jats:italic>P<\/jats:italic> &lt; .0001) throughout the study period. Although initial care at the Emergency Department (ED) remained the most common type of initial concussion\u2010related health care utilization for rural children throughout the study period, the most common type of initial care sought by urban children shifted over time from the ED to primary care providers (PCPs). For both rural and urban children, PCPs remained the most common type of follow\u2010up care sought throughout the study period, with no significant rural\u2010urban differences in the trends of follow\u2010up care sought through PCPs over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We observed significant rural\u2010urban differences in the trends in rates and types of concussion\u2010related health care utilization over time from 2008 to 2016. Future studies are needed to further our understanding of the effect of these observed rural\u2010urban differences on concussion recovery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12484","type":"journal-article","created":{"date-parts":[[2020,8,3]],"date-time":"2020-08-03T15:20:39Z","timestamp":1596468039000},"page":"479-486","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Concussion\u2010Related Health Care Utilization Among Medicaid Insured Children in Ohio: Rural and Urban Differences"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8079-0388","authenticated-orcid":false,"given":"Lindsay","family":"Sullivan","sequence":"first","affiliation":[{"name":"Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Newton","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junxin","family":"Shi","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teng\u2010Jen","family":"Chang","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingzhen","family":"Yang","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy The Research Institute at Nationwide Children's Hospital  Columbus Ohio"},{"name":"Department of Pediatrics The Ohio State University College of Medicine  Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,8,3]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6810a2"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2014.2320"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-49.3.30"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2012.301107"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.0338"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0363546517738742"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/PEC.0000000000000325"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40621-015-0034-7"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.05.036"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmr.2015.12.006"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.3979"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2018.10.021"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.2009.00192.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2015.04.001"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1748-0361.2006.00022.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182aafdf5"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40621-015-0063-2"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.155.7.784"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1047-2797(96)00150-0"},{"issue":"12","key":"e_1_2_6_21_1","first-page":"318","article-title":"Traumatic brain injury: outcomes from rural and urban locations over a 5\u2010year period (Part 1)","volume":"66","author":"Chapital AD","year":"2007","journal-title":"Hawaii Med J"},{"key":"e_1_2_6_22_1","unstructured":"Partners For Kids.About Us. partnersforkids.org.https:\/\/partnersforkids.org\/about\/. 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