An analysis of referees and referrals to a specialist concussion clinic in New Zealand.
OBJECTIVE
This study reviews the characteristics of referrals to a specialist concussion clinic (Burwood Hospital Concussion Clinic, Christchurch, New Zealand) in its first two years of operation.


METHODS
Information regarding referral source, demographic and clinical features, time since mild traumatic brain injury (MTBI), assessment and treatment provided, service follow-up, and outcome at discharge were collected from a file search of all referrals received in the two years ending in October 2004.


RESULTS
Cases reflected the clinical and demographic diversity expected of those incurring an MTBI. Age and referral source were associated with failing to keep initial appointments. Assessments typically resulted in ongoing treatment from the service, although many were 'one-off' assessments. One-in-five cases resulted in ongoing treatment for more than 7 months. Gender, cause of MTBI, and time delay between injury and assessment were significantly associated with receiving long-term follow-up. Most cases had a good clinical outcome at discharge.


CONCLUSIONS
While the Concussion Clinic services the intended clinical population, referrals for assault-related MTBIs were greater than expected, and men may be under-referred. The disproportional number of non-attending patients referred from Christchurch Hospital Emergency Department along with the unanticipated proportion of cases receiving long-term follow-up, suggest a need for review of the referral response systems and the scope of service provision.
Brain Injury Rehabilitation Service, Burwood Hospital, Canterbury District Health Board, Christchurch, New Zealand. deborah.snell@cdhb.govt.nz
Deborah
D
Snell
Lois
L
Surgenor
D000058:Accidental Falls / Q000706:statistics & numerical data; D000328:Adult; D017677:Age Distribution; D001924:Brain Concussion / Q000453:epidemiology* / Q000628:therapy; D015984:Causality; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009520:New Zealand; D009784:Occupational Diseases / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010044:Outpatient Clinics, Hospital / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D017678:Sex Distribution; D016312:Treatment Refusal / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data