{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T19:23:33Z","timestamp":1740425013434,"version":"3.37.3"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R03HD104206"],"award-info":[{"award-number":["R03HD104206"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec040\">\n<jats:title>Background<\/jats:title>\n<jats:p>Traumatic brain injury is a chronic disease with lifelong consequences. In children, it can affect developmental milestones. Longitudinal data on brain injury and long-term healthcare use is limited, with lack of clarity on social determinants of health and its effects on healthcare use. This study explores rates of healthcare use, from birth, and up to 10 years after a childhood traumatic\u00a0brain injury-related healthcare visit.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec041\">\n<jats:title>Methods and findings<\/jats:title>\n<jats:p>This study uses a population-based birth cohort of individuals born between April 1, 2002 and March 31, 2020 from Ontario, Canada. A case cohort (TBI cohort) was created using a sample of individuals who had at least one traumatic brain injury-related healthcare visit between the ages of 0 and 4 years, inclusive (n\u2009=\u200926,988). Controls were generated from a sample of individuals who did not have any traumatic brain injury-related healthcare visit during the study period (n\u2009=\u2009193,253 for emergency department visits and hospitalizations, and n\u2009=\u200919,313 for primary care physician visits). The primary outcome is rates of primary care physician visits, emergency department visits, and hospitalizations for each year prior to and up to 10 years after the index traumatic brain injury-related healthcare visit, calculated using standard life table methods. Rates and 95% confidence intervals were further calculated and stratified by rurality of residence, and the following Ontario Marginalization Index metrics: neighbourhood income quintile and neighbourhood racialized and newcomer populations. <\/jats:p>\n<jats:p>Rates of healthcare use remained consistently higher in the TBI cohort compared to controls both prior to and after the index TBI-related healthcare visit. Rates also varied across social determinants of health. Overall, rates were higher in males compared to females across all healthcare settings. Rates of primary care physician visits were higher among those living in urban (vs. rural) settings. However, rates of emergency department visits were higher among those living in rural (vs. urban) settings. Rates of emergency department visits and hospitalizations were higher among those living in the lowest (vs. highest) income quintile neighbourhoods. Rates of primary care physician visits were higher among those living in areas with the most (vs. least) racialized and newcomer populations. However, rates of emergency department and hospitalizations were higher among those living in areas with the least (vs. most) racialized and newcomer populations. This study is limited to change in rates of healthcare use over time and does not quantify the magnitude of these changes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec042\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Research on longitudinal healthcare use is needed to explore the causes of sustained and increased healthcare use post-injury, to inform opportunities for targeted health and social care interventions. Findings also suggest that a lifespan perspective is critical to understand how early life events can impact post-injury outcome.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0316165","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T18:33:13Z","timestamp":1740421993000},"page":"e0316165","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Longitudinal healthcare use after pediatric brain injury: A population-based birth cohort study"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6884-044X","authenticated-orcid":true,"given":"Vincy","family":"Chan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Clarissa Serafine","family":"Wirianto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert","family":"Balogh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael David","family":"Escobar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,2,24]]},"reference":[{"issue":"1","key":"pone.0316165.ref001","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/S1474-4422(18)30415-0","article-title":"Global, regional, and national burden of traumatic brain injury and spinal cord injury, 1990\u20132016: a systematic analysis for the global burden of disease study 2016.","volume":"18","author":"SL James","year":"2019","journal-title":"Lancet 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Neurol"},{"issue":"1","key":"pone.0316165.ref005","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1177\/0883073814568152","article-title":"Pediatric posttraumatic headache","volume":"31","author":"MC Choe","year":"Jan","journal-title":"J Child Neurol"},{"issue":"6","key":"pone.0316165.ref006","doi-asserted-by":"crossref","first-page":"684","DOI":"10.3171\/2018.6.PEDS1813","article-title":"Nationwide incidence and risk factors for posttraumatic seizures in children with traumatic brain injury","volume":"22","author":"K Rumalla","year":"2018","journal-title":"J Neurosurg Pediatr"},{"issue":"8","key":"pone.0316165.ref007","doi-asserted-by":"crossref","first-page":"1536","DOI":"10.3390\/jcm4081536","article-title":"Update of endocrine dysfunction following pediatric traumatic brain injury","volume":"4","author":"K Reifschneider","year":"2015","journal-title":"J Clin 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Cristofori","year":"2017","journal-title":"Elsevier"},{"issue":"7","key":"pone.0316165.ref011","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1089\/neu.2011.2144","article-title":"Social function in children and adolescents after traumatic brain injury: a systematic review 1989\u20132011","volume":"29","author":"S Rosema","year":"2012","journal-title":"J Neurotrauma"},{"issue":"1","key":"pone.0316165.ref012","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.psc.2013.11.003","article-title":"Neuropsychiatry of pediatric traumatic brain injury","volume":"37","author":"JE Max","year":"2014","journal-title":"Psychiatr Clin North Am"},{"key":"pone.0316165.ref013","article-title":"Report to Congress: The Managment of Trauamtic Brain Injury in Children","year":"2018"},{"issue":"5","key":"pone.0316165.ref014","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1007\/s10597-014-9814-8","article-title":"The Role of gender and income in predicting barriers to mental health care in Canada","volume":"51","author":"AK Slaunwhite","year":"2015","journal-title":"Community Ment Health J"},{"issue":"5","key":"pone.0316165.ref015","doi-asserted-by":"crossref","first-page":"620","DOI":"10.1080\/02699052.2017.1283057","article-title":"Lifetime prevalence of traumatic brain injury in a demographically diverse community sample","volume":"31","author":"J Kisser","year":"2017","journal-title":"Brain Inj"},{"issue":"7","key":"pone.0316165.ref016","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1080\/02699052.2018.1470331","article-title":"Psychiatric diagnoses of children affected by their parents\u2019 traumatic brain injury: the 1987 finnish birth cohort study","volume":"32","author":"L Kinnunen","year":"2018","journal-title":"Brain Inj"},{"issue":"8","key":"pone.0316165.ref017","doi-asserted-by":"crossref","first-page":"e1002103","DOI":"10.1371\/journal.pmed.1002103","article-title":"Long-term outcomes associated with traumatic brain injury in childhood and adolescence: a nationwide swedish cohort study of a wide range of medical and social outcomes","volume":"13","author":"A Sariaslan","year":"2016","journal-title":"PLoS Med"},{"issue":"10","key":"pone.0316165.ref018","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1007\/s10654-024-01158-w","article-title":"Cohort profile: a population-based birth cohort of traumatic brain injury in Ontario, Canada","volume":"39","author":"V Chan","year":"2024","journal-title":"Eur J Epidemiol"},{"issue":"3","key":"pone.0316165.ref019","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/070674370705200312","article-title":"Socioeconomic status and self-reported barriers to mental health service use","volume":"52","author":"L Steele","year":"2007","journal-title":"Can J Psychiatry. Revue canadienne de psychiatrie"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0316165","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T18:33:24Z","timestamp":1740422004000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0316165"}},"subtitle":[],"editor":[{"given":"Masaki","family":"Mogi","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,2,24]]},"references-count":19,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2,24]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0316165","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,24]]}}}