7.7 Increased Utilization of Healthcare Professionals in the Assessment and Management of Sport-Related Concussions in United States High Schools, 2005/06 Through 2020/21 Academic Years

ObjectiveDue to increased concussion education and the passage of state-level return to play laws in the United States (US), the healthcare network engaged in concussion recovery among high school athletes may have changed over time. The objective of this study was to evaluate the involvement of healthcare professionals in the assessment and management of sport-related concussions (SRCs).DesignDescriptive epidemiology study.SettingData from the National High School Sports-Related Injury Surveillance Study, otherwise known as High School RIO, were analyzed.ParticipantsAthletes in the US at a high school with an Athletic Trainer (AT).Independent VariablesTime period (pre-legislation: 2005/06–2008/09; during legislation: 2009/10–2013/14; post-legislation: 2014/15–2020/21).Outcome MeasuresTypes of healthcare professionals who assessed/managed concussions were described using frequencies and percentages.Main ResultsThe 20,268 reported concussions were most commonly assessed/managed by an AT (93.5%), general physician/pediatrician (58.6%), and/or orthopedic/sports medicine physician (19.7%). Before concussion legislation was passed, 51.7% of concussions were assessed/managed by one healthcare professional compared to 30.2% during legislation and 21.0% post-legislation. Concussions assessed/managed by two healthcare professionals increased from 43.4% pre-legislation to 58.6% during legislation and 68.5% post-legislation. Concussions assessed/managed by three or more healthcare professionals increased from 4.6% pre-legislation to 10.6% during legislation and 10.5% post-legislation.ConclusionsA larger, more diverse network of healthcare professionals is currently involved in the assessment and management of SRCs among high school athletes compared to before concussion return to play laws were enacted. Evolutions in healthcare provisions should be considered when examining injury patterns over time.