Vincy Chan, Clarissa Serafine Wirianto, Robert Balogh, Michael David Escobar
Abstract
Traumatic brain injury is a chronic disease with lifelong consequences. In children, it can affect developmental milestones. Longitudinal data on brain injury and long-term healthcare use is limited, with lack of clarity on social determinants of health and its effects on healthcare use.
Introduction
Traumatic brain injury (TBI) is a leading cause of death and disability worldwide. In 2016, there were over 27 million new cases of TBI globally, of which 47% were among children and adolescence [1]. TBIs are of particular concern among children because consequences of a TBI sustained during childhood may not be immediately apparen
Methods
Research ethics approval was obtained from the University Health Network. Informed consent was not obtained because only de-identified data were received from ICES for this study. De-identified data were accessed by the research team on July 30, 2021.
Results
In the TBI cohort, 56.9% were males and, at the time of index TBI-related healthcare visit, 7.9% lived in rural neighbourhoods, 20.8% lived in the lowest income quintile neighbourhoods, and 34.3% lived in areas with the most racialized and newcomer populations.
Discussion
This is the first study, to the best of our knowledge, to follow children from birth up to 10 years post-TBI and compare their rates of healthcare use to children who did not have any TBI-related healthcare visits during the study period. Rates of healthcare use remained consistently higher in the TBI cohort compared to controls, up to 10 years post-injury.
Conclusion
Preliminary analysis of longitudinal healthcare use from a population-based birth cohort showed that rates of healthcare use among the TBI cohort was consistently higher than that of controls, before the first TBI-related healthcare visit, and up to 10-years after this index visit, and differed by SDoH.
Citation: Chan V, Wirianto CS, Balogh R, Escobar MD (2025) Longitudinal healthcare use after pediatric brain injury: A population-based birth cohort study. PLoS ONE 20(2): e0316165. https://doi.org/10.1371/journal.pone.0316165
Editor: Masaki Mogi, Ehime University Graduate School of Medicine, JAPAN
Received: September 3, 2024; Accepted: December 6, 2024; Published: February 24, 2025
Copyright: © 2025 Chan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Data Availability: The dataset from this study is held securely in coded form at ICES. While legal data sharing agreements between ICES and data providers (e.g., healthcare organizations and government) prohibit ICES from making the dataset publicly available, access may be granted to those who meet pre-specified criteria for confidential access, available at www.ices.on.ca/DAS (email: das@ices.on.ca). The full dataset creation plan and underlying analytic code are available from ICES upon request.
Funding: Research reported in this publication was supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award Number R03HD104206. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The content is solely the responsibility of the authors and does not necessarily represent the views of the National Institutes of Health. URL: https://www.nichd.nih.gov/grants-contracts.
Competing interests: The authors have declared that no competing interests exist.
