Are concussion patients getting good follow up care? So far, the data clearly says no. Indeed, less than 50% of concussion patients treated at major trauma centers received follow-up care by three months after discharge.
Millions of Americans go to the hospital each year for concussion treatment. Though rarely fatal, concussions do have long-term effects that decrease quality of life. These include headaches, trouble with memory and reasoning, difficulty sleeping, and depression. A recent study found that almost 25% of people with mild concussions still have related physical or mental problems one year later.
Other studies show that many patients with mild concussions do not receive enough follow-up care to help them overcome these problems. A research team at USC and UC San Francisco studied nationwide follow-up concussion care. They followed 831 people who were treated for mild concussions at 11 major trauma centers across the country. All the participants had symptoms that triggered a CT scan of their brain as part of initial treatment. Traffic accidents and falls accounted for most of the cases.
Concussion: Study Results
The participants were asked about their follow-up care using two surveys, collected two weeks and then again three months after their injury. They reported whether they had received educational materials about their concussion when leaving the hospital, and if the hospital had called to check up on them. Another question was if they had seen a doctor or other health care practitioner since going home. The research was supported in part by NIH’s National Institute of Neurological Disorders and Stroke (NINDS). Results were published in JAMA Network Open on May 25, 2018.
Overall, about 42% of the participants said they had received educational materials when leaving the hospital. Only 27% received a follow-up call from the hospital. Within three months of their injury, 44% had seen a health-care professional. These percentages varied widely between hospitals. Centers with dedicated concussion clinics provided the highest rates of follow-up care.
People with more serious head injuries were more likely to receive follow-up care. Out of 236 participants who had tissue damage on their initial CT scan, 61% had seen a doctor three months after their injury and 39% had not. Of the 279 participants who reported that they still had three or more moderate or severe symptoms from their concussion three months later, only 50% had seen a doctor about those symptoms. Whether or not people had health insurance did not affect the rates of follow-up care.
In the best trauma centers in the country, concussion patients are not getting the necessary longer term follow-up care they really need.