New data published in JAMA Pediatrics indicate that far too many children suspected of having a concussion are evaluated first in a primary care office. Between 2010 and 2014, 81.9% of young patients ultimately seen at Children’s Hospital of Philadelphia (CHOP) had their first concussion-related healthcare visit in the primary care setting. Urgent care was a nonfactor, as the remainder sought care first in the emergency room (not surprising, given that the data set was culled from electronic health records at CHOP). The younger the patient, the more likely families were to seek care in the ED first—eg, 52% of children ≤4 years of age were first seen in the emergency setting. Payer status was also a factor, as more Medicaid patients went to the ED first for concussion care (37%) compared with privately insured patients (7%) and self-pay patients (24%). The take-home message for urgent care operators is that parents, schools, community sports organizers, and summer camps must be made aware that urgent care centers are fully capable of evaluating children suspected of having a concussion immediately—certainly much sooner than is likely in a primary care setting and often faster and at lower cost than in the ED.
Too Many Kids Head to Primary Care, Not Urgent Care, with Suspected Concussions