Uses of Health Care System Medical Care Services by Athletes After Injury at the High School Level.
Garrett S Bullock, John F Mobley, John M Brooks and 4 others
PMID 36263850WHAT IT FOUND
Athletes from lower socioeconomic schools used more emergency department and physical therapy services after injury, even though injuries were similarly common.
Ask which outside provider the family chose, because pathways may differ.
Key findings
01After injury, athletes at lower socioeconomic schools were more likely to use physical therapy and emergency department services than athletes at higher socioeconomic schools.
02Injury incidence did not differ by school socioeconomic status, but athletes at lower socioeconomic schools had more sprains, fractures, and anterior cruciate ligament tears.
03Physician office visits, imaging, and surgery were not associated with school socioeconomic status in the main analyses.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
It covered one large school district in South Carolina, and most care came from one local sports medicine group, so it may not apply to other regions or health systems. Socioeconomic status was measured at the school level using free and reduced-price lunch percentage, not each athlete's household income, so the study cannot show what individual athletes' finances did. Athletes and families chose outside providers independently, so differences in service use may reflect access, insurance, transportation, literacy, language, cultural factors, or provider preference rather than injury severity. The study could not calculate athlete exposure or injury rates, and care outside the county system may have been missed, although less than 1% of services came from outside the county system. It described health service use after injury, not treatment quality, appropriateness, or recovery outcomes, so it cannot show whether any service helped or harmed athletes. The authors state that the statistically significant estimates should not be used to guide policy changes.
Declared interests
The authors declare they have no conflicts of interest.
The easy way to misread this
Do not conclude that emergency department use was inappropriate or that physical therapy use shows treatment benefit. The study counted services used after injury, not their quality, appropriateness, or effect on recovery, and families chose providers independently.