Staffing, financial, and administrative oversight models and rates of injury in collegiate athletes

Abstract

Context: Structural features of health care environments are associated with patient health outcomes, but these relationships are not well understood in sports medicine. Objective: To evaluate the association between athlete injury outcomes and structural measures of health care at universities: (1) clinicians per athlete, (2) financial model of the sports medicine department, and (3) administrative reporting structure of the sports medicine department. Design: Descriptive epidemiology study. Setting: Collegiate sports medicine programs. Patients or Other Participants: Colleges that contribute data to the National Collegiate Athletic Association (NCAA) Injury Surveillance Program. Main Outcome Measure(s): We combined injury data from the NCAA Injury Surveillance Program, sports medicine staffing data from NCAA Research, athletic department characteristics from the United States Department of Education, and financial and administrative oversight model data from a previous survey. Rates of injury, reinjury, concussion, and time loss (days) in NCAA athletes. Results: Compared with schools that had an average number of clinicians per athlete, schools 1 standard deviation above average had a 9.5% lower injury incidence (103.6 versus 93.7 per 10000 athlete-exposures [AEs]; incidence rate ratio [IRR] = 0.905, P