To identify and present socioeconomic risk factors for failure to follow-up after referral for specialized concussion management; to suggest opportunities for reducing these risks and their associated negative outcomes

Disparities in utilization of specialty care for concussion and traumatic brain injury (TBI) are well established. Racial and ethnic disparities have been shown to exist for neurologic care overall (Saadi 2017), in utilization of outpatient rehabilitation (Jimenez 2016) and mental health (Jimenez 2017) services after TBI, and in access to concussion care in Sports Medicine clinics (Copley 2020). Given the potential impacts of this issue for public health and racial equity, and to mitigate the risk of negative health outcomes because of these disparities, more work is needed to understand the factors leading to modifiable differences in concussion management.

Retrospective chart review was performed on a specialized work-queue in the electronic medical record (EMR) in a large health system with blended rural, suburban, and urban populations. Over 2.5 years, 900 patients were referred to the system’s concussion management program. 447 patients failed to complete referral pathways as recommended. We examined the demographics of our patient population and compared our findings to the current literature on the epidemiology of sports concussion.

Preliminary results contradict past epidemiology statistics regarding socioeconomic status but reaffirm racial disparities in patients who received referral to our specialized concussion management network. Results show differences in adherence to treatment for sport-related concussion and other mechanisms of injury as well as racial and socioeconomic differences for sport and non-sport related concussions.

Comparing our sample data to recent literature on disparities in neurological concussion management will help identify weaknesses in providing neurological care after concussion or other mild TBI. Further work is needed to better understand patient experience in concussion care disparities and to compare our inferences to patients’ lived experiences.