Medical Student Vanderbilt University School of Medicine
Disclosure(s):
Jacob Jo, BA: No financial relationships to disclose
Introduction: While evidence suggests that delayed time to healthcare presentation is associated with prolonged recovery following sports-related concussion (SRC), social demographics have not been explored for their influence on time to evaluation. Our study aimed to investigate whether social demographics are associated with time to evaluation following SRC.
Methods: A retrospective, cohort study was conducted in a regional sports concussion center between 11/2017-04/2022. Participants were adolescents (12-18 years old) who sustained a SRC. Exposure variables of interest included: school type (public/private), insurance (public/private), race, and ethnicity. The primary outcome was time to healthcare presentation, dichotomized into time to generalist (any healthcare provider) and time to a specialist (sport concussion center provider). Chi-square analysis and multivariable logistic regression were performed.
Results: Among 945 participants, the mean age of athletes was 15.8±1.61. The mean time to generalist and specialist presentation were 3.0±3.39 and 6.8±9.03 days, respectively. Chi-square analyses showed that public school athletes were more likely to present to any healthcare provider within one week compared to private school athletes (X2=5.05, p=0.025). Participants with private insurance (X2=7.32, p=0.007) and those who identified as “not Hispanic or Latino” (X2=5.87, p=0.015) were more likely to present to a specialist within one week of injury. Additionally, multivariable linear regressions controlling for age, sex, concussion severity, and number of prior concussions found that school type (p= < 0.001) was significantly associated with time to generalist, while ethnicity (p=0.027) and insurance status (p=0.045) were associated with time to specialist.
Conclusion : Our findings suggest that athletes’ social demographics influence time to healthcare presentation, such that private school, certain ethnicities, and public insurance were associated with longer time to generalist and specialist presentations. Further research is needed to confirm these findings and determine the mechanism by which these social demographics impact delayed presentation times.
