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Updated: Oct 19, 2025
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Healthcare utilization and costs associated with persistent post-concussive symptoms
Sabrina Agnihotri1,2, Melanie Penner1,3, Kylie D Mallory1
1Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada.
Insights
Interdisciplinary care for pediatric persistent post-concussive symptoms (PPCS) is accessible and comprehensive. This healthcare model proves cost-saving for both patients and society.
Area of Science:
- Pediatric Neurology
- Healthcare Management
- Rehabilitation Medicine
Background:
- Pediatric persistent post-concussive symptoms (PPCS) require specialized management.
- Understanding healthcare utilization and associated costs is crucial for optimizing treatment pathways.
Purpose of the Study:
- To evaluate healthcare utilization and costs for interdisciplinary treatment of pediatric persistent post-concussive symptoms (PPCS).
Main Methods:
- Retrospective chart review of 461 youth treated at an interdisciplinary PPCS outpatient clinic.
- Analysis of healthcare utilization (accessibility, continuity, comprehensiveness, productivity) and direct/indirect costs.
- Descriptive statistical analysis of collected data.
Main Results:
- Median physician consultation wait time was 71 days; other services <2 months.
- 82% of clients received referrals to additional services, with occupational therapy being most common (79%).
- Median direct costs were ~$915/client, with total costs of $532,623; indirect costs were ~$387/family.
Conclusions:
- Interdisciplinary PPCS care is an accessible and comprehensive healthcare model.
- This model demonstrates cost-saving benefits from both client and societal perspectives.
- Findings support the adoption of integrated care approaches for pediatric concussion management.
Objective:
To describe the healthcare utilization and costs associated with the interdisciplinary treatment of pediatric persistent post-concussive symptoms (PPCS).
Methods:
A retrospective chart review was conducted with 461 youth referred by community physicians to an interdisciplinary pediatric PPCS outpatient clinic in Ontario, Canada. Healthcare utilization parameters included accessibility, continuity, comprehensiveness, and service productivity. Direct healthcare costs included those incurred by physicians and other interdisciplinary services. Indirect costs per client included travel to the clinic and caregiver productivity loss. Data analyses were completed using descriptive statistics.
Results:
The median age of clients was 15 years (range = 3 to 18). The median wait time for an initial PPCS clinic physician consultation was 71 days, and less than 2 months for other interdisciplinary services. Eighty-two percent of clients were referred to at least one other service after an initial physician consultation. Occupational therapy received the highest proportion of referrals (79%). Total median direct costs per client were approximately $915, with a final accumulated cost of $532 623 for all clients. Caregiver productivity loss was approximately $387 per family.
Conclusions:
Our findings suggest that interdisciplinary PPCS care represents an accessible, comprehensive and cost-saving healthcare model from the client and societal perspectives.
