142nd APHA Annual Meeting and Exposition

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315536
Defining Children and Youth with Traumatic Brain Injury: Implications for the Organization and Preparation of Healthcare Services

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Vincy Chan, MPH, PhD Candidate , Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
Robert Mann, PhD , Centre for Addiction and Mental Health, Toronto, ON, Canada
Angela Colantonio, PhD, OT Reg. (Ont.), FACRM , Graduate Department of Rehabilitation Science, University of Toronto, Toronto, ON, Canada
Background: Traumatic brain injury (TBI) is a leading cause of death and disability worldwide and can result in severe and long-term consequences for the individual, the families, and the healthcare system. There is currently no consensus on the case definitions to define TBI despite the importance of accurately capturing this population for surveillance and research informing prevention, planning of healthcare services, and advocacy.

Objective: To compare the number, profile, and outcome of children and youth aged 0 to 19 years by different TBI case definitions.

Method: Healthcare administrative data from Ontario, Canada, were used to identify TBI cases between 2003/04 and 2009/10. TBI case definitions ranging from specific to broad and the head injury case definition were compared.

Results: The rate of TBI ranged from 250.0 to 2,667.2 per 100,000 depending on the case definition. The more conservative case definition was associated with a significantly higher proportion of patients with special care days (p<.001), longer length of stay (p<.001), and death in acute care (p<.001) and discharge to inpatient rehabilitation (p<.001).

Conclusion: A range of case definition should be considered for prevention and post-injury care research and planning for children and youth with TBI. A case definition with high sensitivity is preferred for prevention and a case definition with high specificity is preferred for planning and organizing post-injury healthcare services.

Learning Areas:

Chronic disease management and prevention
Epidemiology
Public health administration or related administration

Learning Objectives:
Describe the results and implications of different case definitions currently used for identifying traumatic brain injury in children and youth in healthcare administrative data

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Vincy Chan is a PhD candidate at the University of Toronto has a MPH in Epidemiology from the University of Toronto. Her research focuses on a population based perspective of children and youth with acquired brain injury. She is currently the lead analyst for the Ontario Acquired Brain Injury Dataset, the first surveillance dataset that captures both acquired brain injury across the continuum of care in Ontario, Canada.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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