Researchers reveal “leaky pipeline” driving disparities in pediatric concussion care
“Leaky pipeline” in pediatric concussion care shows disparities in diagnosis and recovery.
Researchers uncovered a “leaky pipeline” in pediatric concussion care where disparities grow from diagnosis through recovery due to barriers facing patients and families.
Published in the Journal of Pediatrics, the study, led by Children’s Hospital of Philadelphia and co-led by Children’s National Hospital, drew on one of the nation’s largest pediatric concussion registries, spanning tens of thousands of patients, to examine how disparities emerge during the full spectrum of treatment from diagnosis, referral to specialty care and follow-up based on factors such as demographics, insurance status and a composite measure of factors important to child health and development called the Child Opportunity Index.
Why it matters
“By conceptualizing pediatric concussion care as a ‘leaky pipeline,’ this work provides a new framework for understanding and addressing inequities across acute injury care, informing future system-level solutions that can be applied well beyond head trauma,” said Sadiqa Kendi, MD, pediatric emergency physician who serves as associate chief of Academic Affairs and Research for the Division of Emergency Medicine at Children’s National Hospital, chief medical officer of Safe Kids Worldwide and co-author of the study.and co-author of the study.
Of more than 22,000 patients, steep drop-offs emerged at every stage based on patients’ age, race, insurance status and opportunity and disparities compounded as the care pathway progressed.
The big picture
“It’s important that every pediatric patient with head trauma, no matter how, where or when they first interact with the healthcare system, receives care that aligns with our best-practice evidence,” said study lead author Daniel J. Corwin, MD, MSCE, director of clinical and translational research in the Division of Emergency Medicine and associate director of the Minds Matter Concussion Program at CHOP. “By understanding where patients might fall away from the optimal care journey, we can develop strategies that ensure no patient is left behind.”
Building on these findings, researchers are advancing targeted solutions across two major studies. These include electronic health record (EHR)-based tools to standardize concussion diagnosis and risk stratification, as well as innovative patient management approaches that track recovery in real time and strengthen engagement beyond the clinic. Together, these efforts aim to address barriers as they emerge and reduce disparities across the care pathway.
Read more from Children’s Hospital of Philadelphia.
