{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T21:23:58Z","timestamp":1783718638951,"version":"3.55.0"},"reference-count":27,"publisher":"National Athletic Trainers' Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,23]]},"abstract":"<jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Structural features of health care environments are associated with patient health outcomes, but these relationships are not well understood in sports medicine.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the association between athlete injury outcomes and structural measures of health care at universities: (1) clinicians per athlete, (2) financial model of the sports medicine department, and (3) administrative reporting structure of the sports medicine department.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Descriptive epidemiology study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Collegiate sports medicine programs.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients or Other Participants<\/jats:title>\n                  <jats:p>Colleges that contribute data to the National Collegiate Athletic Association (NCAA) Injury Surveillance Program.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main Outcome Measure(s)<\/jats:title>\n                  <jats:p>We combined injury data from the NCAA Injury Surveillance Program, sports medicine staffing data from NCAA Research, athletic department characteristics from the United States Department of Education, and financial and administrative oversight model data from a previous survey. Rates of injury, reinjury, concussion, and time loss (days) in NCAA athletes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Compared with schools that had an average number of clinicians per athlete, schools 1 standard deviation above average had a 9.5% lower injury incidence (103.6 versus 93.7 per 10000 athlete-exposures [AEs]; incidence rate ratio [IRR] = 0.905, P &amp;lt; .001), 2.7% lower incidence of reinjury (10.6 versus 10.3 per 10000 AEs; IRR = 0.973, P = .004), and 6.7% lower incidence of concussion (6.1 versus 5.7 per 10000 AEs; IRR = 0.933, P &amp;lt; .001). Compared with the average, schools that had 1 standard deviation more clinicians per athlete had 16% greater injury time loss (5.0 days versus 4.2 days; IRR = 1.16, P &amp;lt; .001). At schools with sports medicine departments financed by or reporting to the athletics department (or both), athletes had higher injury incidences (31% and 9%, respectively).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The financial and reporting structures of collegiate sports medicine departments as well as the number of clinicians per athlete were associated with injury risk. Increasing the number of sports medicine clinicians on staff and structuring sports medicine departments such that they are financed by and report to a medical institution may reduce athlete injury incidence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.4085\/1062-6050-0517.19","type":"journal-article","created":{"date-parts":[[2020,4,29]],"date-time":"2020-04-29T16:19:06Z","timestamp":1588177146000},"page":"580-586","source":"Crossref","is-referenced-by-count":26,"title":["Staffing, Financial, and Administrative Oversight Models and Rates of Injury in Collegiate Athletes"],"prefix":"10.4085","volume":"55","author":[{"given":"Christine M.","family":"Baugh","sequence":"first","affiliation":[{"name":"Interfaculty Initiative in Health Policy, Harvard University, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"III","given":"William P.","family":"Meehan","sequence":"first","affiliation":[{"name":"Division of Sports Medicine, Sports Concussion Clinic, Boston Children's Hospital, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"McGuire","sequence":"first","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, MA. Dr Baugh is now at the Center for Bioethics and Humanities, School of Medicine, Department of Medicine, Division of General Internal Medicine, University of Colorado, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura A.","family":"Hatfield","sequence":"first","affiliation":[{"name":"Department of Health Care Policy, Harvard Medical School, Boston, MA. Dr Baugh is now at the Center for Bioethics and Humanities, School of Medicine, Department of Medicine, Division of General Internal Medicine, University of Colorado, Aurora"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2557","published-online":{"date-parts":[[2020,4,29]]},"reference":[{"key":"2020062416090802700_i1062-6050-55-6-580-b01","unstructured":"Student-athlete participation 1981\u201382\u20132018\u20132019: NCAA sports sponsorship and participation rates report.\n\t\t\t\t\tNational Collegiate Athletic Association Web site.\n\t\t\t\t\thttps:\/\/ncaaorg.s3.amazonaws.com\/research\/sportpart\/2018-19RES_SportsSponsorshipParticipationRatesReport.pdf. Published November 2019. Accessed February 28,2020."},{"key":"2020062416090802700_i1062-6050-55-6-580-b02","unstructured":"Hootman\n              JM,\n            \n            \n              Dick\n              R,\n            \n            \n              Agel\n              J.\n            \n          \n          Epidemiology of collegiate injuries for 15 sports: summary and recommendations for injury prevention initiatives.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2007;\n\t\t\t\t\t42(2):\n\t\t\t\t\t311\u2013\n\t\t\t\t\t319."},{"key":"2020062416090802700_i1062-6050-55-6-580-b03","doi-asserted-by":"crossref","unstructured":"Kerr\n              ZY,\n            \n            \n              Dompier\n              TP,\n            \n            \n              Snook\n              EM,\n            \n            et al.\n\t\t\t\t\t\n          National Collegiate Athletic Association Injury Surveillance System: review of methods for 2004\u20132005 through 2013\u20132014 data collection.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2014;\n\t\t\t\t\t49(4):\n\t\t\t\t\t552\u2013\n\t\t\t\t\t560.","DOI":"10.4085\/1062-6050-49.3.58"},{"key":"2020062416090802700_i1062-6050-55-6-580-b04","unstructured":"NCAA Injury Surveillance Program publications.\n\t\t\t\t\tDatalys Center for Sports Injury Research and Prevention Web site.\n\t\t\t\t\thttp:\/\/www.datalyscenter.org\/publications\/. Accessed November 22,2019."},{"key":"2020062416090802700_i1062-6050-55-6-580-b05","doi-asserted-by":"crossref","unstructured":"Kerr\n              ZY,\n            \n            \n              Lynall\n              RC,\n            \n            \n              Mauntel\n              TC,\n            \n            \n              Dompier\n              TP.\n            \n          \n          High school football injury rates and services by athletic trainer employment status.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2016;\n\t\t\t\t\t51(1):\n\t\t\t\t\t70\u2013\n\t\t\t\t\t73.","DOI":"10.4085\/1062-6050-51.3.02"},{"key":"2020062416090802700_i1062-6050-55-6-580-b06","doi-asserted-by":"crossref","unstructured":"Baugh\n              CM,\n            \n            \n              Kroshus\n              E,\n            \n            \n              Daneshvar\n              DH,\n            \n            \n              Filali\n              NA,\n            \n            \n              Hiscox\n              MJ,\n            \n            \n              Glantz\n              LH.\n            \n          \n          Concussion management in United States college sports: compliance with National Collegiate Athletic Association concussion policy and areas for improvement.\n\t\t\t\t\tAm J Sports Med.\n\t\t\t\t\t2015;\n\t\t\t\t\t43(1):\n\t\t\t\t\t47\u2013\n\t\t\t\t\t56.","DOI":"10.1177\/0363546514553090"},{"key":"2020062416090802700_i1062-6050-55-6-580-b07","doi-asserted-by":"crossref","unstructured":"Donabedian\n              A.\n            \n          \n          Evaluating the quality of medical care.\n\t\t\t\t\tMilbank Mem Fund Q.\n\t\t\t\t\t1966;\n\t\t\t\t\t44(suppl 3):\n\t\t\t\t\t166\u2013\n\t\t\t\t\t206.","DOI":"10.2307\/3348969"},{"key":"2020062416090802700_i1062-6050-55-6-580-b08","doi-asserted-by":"crossref","unstructured":"Donabedian\n              A.\n            \n          \n          The quality of care: how can it be assessed?\n          \n            JAMA\n          .\n\t\t\t\t\t1988;\n\t\t\t\t\t260(12):\n\t\t\t\t\t1743\u2013\n\t\t\t\t\t1748.","DOI":"10.1001\/jama.1988.03410120089033"},{"key":"2020062416090802700_i1062-6050-55-6-580-b09","doi-asserted-by":"crossref","unstructured":"Friedberg\n              MW,\n            \n            \n              Coltin\n              KL,\n            \n            \n              Safran\n              DG,\n            \n            \n              Dresser\n              M,\n            \n            \n              Zaslavsky\n              AM,\n            \n            \n              Schneider\n              EC.\n            \n          \n          Associations between structural capabilities of primary care practices and performance on selected quality measures.\n\t\t\t\t\tAnn Intern Med.\n\t\t\t\t\t2009;\n\t\t\t\t\t151(7):\n\t\t\t\t\t456\u2013\n\t\t\t\t\t463.","DOI":"10.7326\/0003-4819-151-7-200910060-00006"},{"key":"2020062416090802700_i1062-6050-55-6-580-b10","doi-asserted-by":"crossref","unstructured":"Linder\n              JA,\n            \n            \n              Ma\n              J,\n            \n            \n              Bates\n              DW,\n            \n            \n              Middleton\n              B,\n            \n            \n              Stafford\n              RS.\n            \n          \n          Electronic health record use and the quality of ambulatory care in the United States.\n\t\t\t\t\tArch Intern Med.\n\t\t\t\t\t2007;\n\t\t\t\t\t167(13):\n\t\t\t\t\t1400\u2013\n\t\t\t\t\t1405.","DOI":"10.1001\/archinte.167.13.1400"},{"key":"2020062416090802700_i1062-6050-55-6-580-b11","unstructured":"Types of health care quality measures.\n\t\t\t\t\tAgency for Healthcare Research and Quality Web site.\n\t\t\t\t\thttps:\/\/www.ahrq.gov\/talkingquality\/measures\/types.html. Published 2015. Accessed November 22,2019."},{"key":"2020062416090802700_i1062-6050-55-6-580-b12","doi-asserted-by":"crossref","unstructured":"Baugh\n              CM,\n            \n            \n              Kroshus\n              E,\n            \n            \n              Lanser\n              BL,\n            \n            \n              Lindley\n              T,\n            \n            \n              Meehan\n              WP\n              III.\n            \n          \n          Sports medicine staffing across National Collegiate Athletic Association Division I, II, and III schools: evidence for the medical model.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2020;\n\t\t\t\t\t55(6):\n\t\t\t\t\t573\u2013\n\t\t\t\t\t579.","DOI":"10.4085\/1062-6050-0463-19"},{"key":"2020062416090802700_i1062-6050-55-6-580-b13","doi-asserted-by":"crossref","unstructured":"Gallucci\n              AR,\n            \n            \n              Petersen\n              JC.\n            \n          \n          The size and scope of collegiate athletic training facilities and staffing.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2017;\n\t\t\t\t\t52(8):\n\t\t\t\t\t785\u2013\n\t\t\t\t\t794.","DOI":"10.4085\/1062-6050-52.3.16"},{"key":"2020062416090802700_i1062-6050-55-6-580-b14","doi-asserted-by":"crossref","unstructured":"Baugh\n              CM,\n            \n            \n              Kerr\n              ZY,\n            \n            \n              Kroshus\n              E,\n            \n            \n              Lanser\n              BL,\n            \n            \n              Lindley\n              T,\n            \n            \n              Meehan\n              WP\n              III.\n            \n          \n          Sports medicine staffing patterns and incidence of injury in collegiate men's ice hockey.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2020;\n\t\t\t\t\t55(6):\n\t\t\t\t\t587\u2013\n\t\t\t\t\t593.","DOI":"10.4085\/1062-6050-0464.19"},{"key":"2020062416090802700_i1062-6050-55-6-580-b15","doi-asserted-by":"crossref","unstructured":"Pierpoint\n              LA,\n            \n            \n              LaBella\n              CR,\n            \n            \n              Collins\n              CL,\n            \n            \n              Fields\n              SK,\n            \n            \n              Comstock\n              RD.\n            \n          \n          Injuries in girls' soccer and basketball: a comparison of high schools with and without athletic trainers.\n\t\t\t\t\tInj Epidemiol.\n\t\t\t\t\t2018;\n\t\t\t\t\t5(1):\n\t\t\t\t\t29.","DOI":"10.1186\/s40621-018-0159-6"},{"key":"2020062416090802700_i1062-6050-55-6-580-b16","doi-asserted-by":"crossref","unstructured":"Kroshus\n              E,\n            \n            \n              Baugh\n              CM,\n            \n            \n              Daneshvar\n              DH,\n            \n            \n              Stamm\n              JM,\n            \n            \n              Laursen\n              RM,\n            \n            \n              Austin\n              SB.\n            \n          \n          Pressure on sports medicine clinicians to prematurely return collegiate athletes to play after concussion.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2015;\n\t\t\t\t\t50(9):\n\t\t\t\t\t944\u2013\n\t\t\t\t\t951.","DOI":"10.4085\/1062-6050-50.6.03"},{"key":"2020062416090802700_i1062-6050-55-6-580-b17","doi-asserted-by":"crossref","unstructured":"Baugh\n              CM,\n            \n            \n              Kroshus\n              E,\n            \n            \n              Stamm\n              JM,\n            \n            \n              Daneshvar\n              DH,\n            \n            \n              Pepin\n              MJ,\n            \n            \n              Meehan\n              WP\n              III.\n            \n          \n          Clinical practices in collegiate concussion management.\n\t\t\t\t\tAm J Sports Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t44(6):\n\t\t\t\t\t1391\u2013\n\t\t\t\t\t1399.","DOI":"10.1177\/0363546516635639"},{"key":"2020062416090802700_i1062-6050-55-6-580-b18","unstructured":"Equity in athletics data analysis.\n\t\t\t\t\tUnited States Department of Education Web site.\n\t\t\t\t\thttps:\/\/ope.ed.gov\/athletics\/#\/. Accessed November 22,2019."},{"key":"2020062416090802700_i1062-6050-55-6-580-b19","doi-asserted-by":"crossref","unstructured":"Rapp\n              GC,\n            \n            \n              Ingersoll\n              CD.\n            \n          \n          Sports medicine delivery models: legal risks.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2019;\n\t\t\t\t\t54(12):\n\t\t\t\t\t1237\u2013\n\t\t\t\t\t1240.","DOI":"10.4085\/1062-6050-83-19"},{"key":"2020062416090802700_i1062-6050-55-6-580-b20","doi-asserted-by":"crossref","unstructured":"Goodman\n              A,\n            \n            \n              Mazerolle\n              SM,\n            \n            \n              Eason\n              CM.\n            \n          \n          Organizational infrastructure in the collegiate athletic training setting, part II: benefits of and barriers in the athletics model.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2017;\n\t\t\t\t\t52(1):\n\t\t\t\t\t23\u2013\n\t\t\t\t\t34.","DOI":"10.4085\/1062-6050-51.12.24"},{"key":"2020062416090802700_i1062-6050-55-6-580-b21","unstructured":"Committee on Competitive Safeguards and Medical Aspects of Sport.\n\t\t\t\t\tIndependent medical care legislation briefing.\n\t\t\t\t\tNational Collegiate Athletic Association Sport Science Institute Web site.\n\t\t\t\t\thttps:\/\/www.ncaa.org\/sites\/default\/files\/SSI_IMC-Briefing-Document_All-Divisions%C2%AD_20170405.pdf. Published April 2017. Accessed November 1,2019."},{"key":"2020062416090802700_i1062-6050-55-6-580-b22","doi-asserted-by":"crossref","unstructured":"Grindem\n              H,\n            \n            \n              Snyder-Mackler\n              L,\n            \n            \n              Moksnes\n              H,\n            \n            \n              Engebretsen\n              L,\n            \n            \n              Risberg\n              MA.\n            \n          \n          Simple decision rules can reduce reinjury risk by 84% after ACL reconstruction: the Delaware-Oslo ACL cohort study.\n\t\t\t\t\tBr J Sports Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t50(13):\n\t\t\t\t\t804\u2013\n\t\t\t\t\t808.","DOI":"10.1136\/bjsports-2016-096031"},{"key":"2020062416090802700_i1062-6050-55-6-580-b23","doi-asserted-by":"crossref","unstructured":"DeFreese\n              JD,\n            \n            \n              Mihalik\n              JP.\n            \n          \n          Work-based social interactions, perceived stress, and workload incongruence as antecedents of athletic trainer burnout.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2016;\n\t\t\t\t\t51(1):\n\t\t\t\t\t28\u2013\n\t\t\t\t\t34.","DOI":"10.4085\/1062-6050-51.2.05"},{"key":"2020062416090802700_i1062-6050-55-6-580-b24","doi-asserted-by":"crossref","unstructured":"Mazerolle\n              SM,\n            \n            \n              Bruening\n              JE,\n            \n            \n              Casa\n              DJ.\n            \n          \n          Work-family conflict, part I: antecedents of work-family conflict in National Collegiate Athletic Association Division IA certified athletic trainers.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2008;\n\t\t\t\t\t43(5):\n\t\t\t\t\t505\u2013\n\t\t\t\t\t512.","DOI":"10.4085\/1062-6050-43.5.505"},{"key":"2020062416090802700_i1062-6050-55-6-580-b25","doi-asserted-by":"crossref","unstructured":"Mazerolle\n              SM,\n            \n            \n              Pitney\n              WA,\n            \n            \n              Casa\n              DJ,\n            \n            \n              Pagnotta\n              KD.\n            \n          \n          Assessing strategies to manage work and life balance of athletic trainers working in the National Collegiate Athletic Association Division I setting.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2011;\n\t\t\t\t\t46(2):\n\t\t\t\t\t194\u2013\n\t\t\t\t\t205.","DOI":"10.4085\/1062-6050-46.2.194"},{"key":"2020062416090802700_i1062-6050-55-6-580-b26","doi-asserted-by":"crossref","unstructured":"Buckley\n              TA,\n            \n            \n              Burdette\n              G,\n            \n            \n              Kelly\n              K.\n            \n          \n          Concussion-management practice patterns of National Collegiate Athletic Association Division II and III athletic trainers: how the other half lives.\n\t\t\t\t\tJ Athl Train.\n\t\t\t\t\t2015;\n\t\t\t\t\t50(8):\n\t\t\t\t\t879\u2013\n\t\t\t\t\t888.","DOI":"10.4085\/1062-6050-50.7.04"},{"key":"2020062416090802700_i1062-6050-55-6-580-b27","doi-asserted-by":"crossref","unstructured":"Finch\n              CF.\n            \n          \n          Getting sports injury prevention on to public health agendas: addressing the shortfalls in current information sources.\n\t\t\t\t\tBr J Sports Med.\n\t\t\t\t\t2012;\n\t\t\t\t\t46(1):\n\t\t\t\t\t70\u2013\n\t\t\t\t\t74.","DOI":"10.1136\/bjsports-2011-090329"}],"container-title":["Journal of Athletic Training"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/55\/6\/580\/2523803\/i1062-6050-55-6-580.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/jat\/article-pdf\/55\/6\/580\/2523803\/i1062-6050-55-6-580.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,11]],"date-time":"2025-06-11T18:50:26Z","timestamp":1749667826000},"score":1,"resource":{"primary":{"URL":"https:\/\/nata.kglmeridian.com\/view\/journals\/attr\/55\/6\/article-p580.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,29]]},"references-count":27,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,4,29]]},"published-print":{"date-parts":[[2020,6,23]]}},"URL":"https:\/\/doi.org\/10.4085\/1062-6050-0517.19","relation":{},"ISSN":["1062-6050"],"issn-type":[{"value":"1062-6050","type":"print"}],"subject":[],"published":{"date-parts":[[2020,4,29]]}}}