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Effects of state legislation on health care utilization for kids with concussion

The JAMA Network Journals

Children with concussion had increased health care utilization which appears to be directly and indirectly related to concussion legislation, according to a study published in JAMA Pediatrics.

Between 1.6 million and 3.8 million sport - and recreation-related concussions are estimated to happen annually in the United States. Most people with concussion return to preinjury functioning but the long-term effects of concussion are not known. Concern over concussions prompted states to pass legislation outlining medical care for children with concussion with all states and the District of Columbia having legislation by January 2014, according to the study background.

Teresa B. Gibson, Ph.D., of Truven Health Analytics, Ann Arbor, Mich., and co-authors looked at the effect of concussion laws on health care utilization rates by commercially insured children (ages 12 to 18) from January 2006 through June 2012 in states with and without legislation.

Study results show that between the academic school years 2008-2009 and 2011-2012, states with legislation saw a 92 percent increase in concussion-related health care utilization, while states without legislation experience a 75 percent overall increase in concussion-related utilization.

The authors estimate that 60 percent of the increase in treated concussion in states without laws resulted from the continuing trend of increasing health care utilization established before the first law was passed. While the sources for the remaining 40 percent increase in utilization were not evaluated, the authors suggest it is due to increased awareness of the injury and concussion-related legislation in other states because of media coverage.

"Concussion legislation has had a seemingly positive effect on health care utilization but the overall increase can also be attributed to increased injury awareness," the study concludes.


(JAMA Pediatr. Published online December 22, 2014. doi:10.1001/jamapediatrics.2014.2320. Available pre-embargo to the media at

Editor's Note: This investigation was supported in part by Truven Health from the National Institute of Child Health and Human Development. Please see article for additional information, including other authors, author contributions and affiliations, etc.

Media Advisory: To contact author Steven P. Broglio, Ph.D., A.T.C., call Emily Mathews at 734-647-3079 or email

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