Family Hardship Following Youth Concussion: Beyond the Medical Bills

J Pediatr Nurs. 2020 Mar-Apr;51:15-20. doi: 10.1016/j.pedn.2019.11.016. Epub 2019 Dec 13.


Purpose: The costs facing families after pediatric concussion are not limited to medical expenses for treatment and rehabilitation care. The objective of this research was to examine the economic hardship facing families following concussion.

Design and methods: Eighteen youth (10-18 years old) with a diagnosed concussion injury and sixteen parents (13 parent/youth dyads) answered open-ended questions regarding experiences associated with concussion care and recovery, specifically as they related to cost. Participants were recruited from a concussion clinic, social media, and via snowball sampling. Interviews were audio recorded, transcribed verbatim, and coded using deductive qualitative content analysis.

Results: In addition to direct health care expenses (e.g. copays and deductibles), families of youth with concussion faced indirect costs associated with tutoring and transportation to medical appointments, in some cases over long distances. Financial cost-sharing for concussion care varied widely across participants.

Conclusions: Lost productivity included parents missing work to care for their child and for travel to appointments. Research that describes costs of care using claims or survey data lack the experiential perspective of the economic burden on families following concussion.

Practice implications: To fully understand the impact of concussion on patients and families, healthcare providers must consider non-monetary costs, such as opportunity costs, transportation required to obtain healthcare, or the productivity cost associated with missed work and school.

Keywords: Adolescents; Concussion; Family; Mild traumatic brain injury; Youth.

MeSH terms

  • Adolescent
  • Brain Concussion* / economics
  • Brain Concussion* / psychology
  • Child
  • Cost of Illness*
  • Family*
  • Female
  • Health Care Costs
  • Health Services Accessibility*
  • Humans
  • Male
  • Parents
  • Surveys and Questionnaires