Traumatic Brain Injury; Trauma; Pediatric; Insurance Status; Health Policy; Disparities


Epidemiology | Health Policy | Health Services Research | Public Health | Trauma


Objective: To review the literature that describes the effects of insurance status on traumatic brain injury (TBI) outcomes among pediatric patients to understand how policies related to access to health insurance changes TBI outcomes. Method: This review was conducted using the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA). A search of OVID Medline was conducted in May of 2016 for all years for peer-reviewed articles that included keywords related to “brain injuries” and “insurance status”. Articles were included if authors conducted a separate analysis of children aged 0 to 18. Articles were excluded if the TBI was the result of abuse. Results: After screening for inclusion and exclusion criteria, a total of 12 articles were analyzed. Discussion/Summary: The findings of this review indicate that insurance status has a significant effect on the health outcomes of pediatric patients who experience TBI, with insured children having lower mortality rates than those with insurance from the government or uninsured. In addition, those insured from the government had a survival benefit when compared to those without insurance. We found evidence that insurance status plays a role in long term outcomes such as rates of placement into rehabilitation facilities and level of disability.