Does Early Access to a Concussion Service Reduce Ongoing Service Utilisation

Abstract

Aim: The primary objective of this study is to describe the patterns of health services utilisation for patients with a mild traumatic brain injury (mTBI) three months after receiving concussion service treatment in New Zealand. This study also investigated unmet needs for persistent symptoms following mTBI, the factors associated with post-concussion symptom recovery and the quality of information received. We compared these outcomes by the timeliness of accessing concussion services (early vs late). Methods: Data on 298 mTBI patients from a large population-based study (Aotearoa Concussion Service Cost-EffectiveneSS study) were used. Health services utilisation, unmet needs, post-concussion symptom recovery and quality of information received were measured using self-reported questionnaires. The data was presented based on presentation time (early vs. late) for each of the measures above. Multivariate linear regression was conducted for the patient demographics to predict health services utilisation and unmet needs. Results: Two hundred and ninety-eight patients were included of which 155 people presented early and 143 presented late. The data contained 86 males, 217 females and two gender-diverse individuals aged 18-85. Forty-four percent reported that the mechanism of their injury was a fall, and 35% reported that the injury took place during daily living activities. Physiotherapy was the most utilised service (63%), followed by occupational therapists (52%). About 20-30% of early-presenting and late-presenting patients were unsatisfied with the care received for headaches and related symptoms. Twenty-one percent of late-presenting patients were dissatisfied with the care received for depression. Over 55% of all participants were satisfied with the support received to return to different activities. However, 20% of all participants received no information to return to driving. Over 22% of patients did not know who to contact at Accident Compensation Corporation (ACC) about their case. No patient demographics predicted patient service utilisation or unmet needs. Conclusion: This study emphasises that physiotherapists and occupational therapists are the most utilised services. Most patients are satisfied with the quality and frequency of information received to return to various activities and the care received for post-concussion symptoms. These findings suggest that once accepted into a concussion service, most patients can obtain the services and care they need and are provided with adequate information.