A - 02 Institutional Gender Composition of Medical Providers and Collegiate Athlete Concussion Recovery Outcomes

Abstract Purpose Research suggests female athletes experience longer recovery trajectories following sports-related concussion. While physiological factors are often proposed to explain these differences, limited attention has focused on systemic factors in concussion care, such as the gender of medical providers. This study aimed to evaluate concussion recovery among athletes at institutions with varying proportions of women providers. Method We reviewed data from 15 institutions participating in the Ivy League–Big Ten Epidemiology of Concussion Study including 525 collegiate athlete concussion cases. We categorized institutions as having a high, moderate, or low proportion of women providers (team physicians and athletic trainers) determined from institutional websites. Using Kaplan–Meier survival curves and Cox proportional hazards regressions, we evaluated the time from injury to recovery milestones, including return-to-contact and return-to-academics, while controlling for patient sex, symptom resolution time, prior concussion history, and injury mechanism. Sensitivity analyses were conducted to remove concussion cases of football athletes. Results Athletes returned-to-contact faster at institutions with a low versus high proportion of women athletic trainers (HR = 1.74, 95% CI: 1.37–2.20, p < 0.01). However, analyses that excluded football players showed no significant differences in recovery times across institutions with varying proportions of women providers. Conclusions We did not find evidence that provider gender improved recovery milestones for collegiate athletes who sustained a concussion. Instead, our results suggest that resource allocation differences between sports may influence recovery trajectories. Future research should consider social factors, like athlete-provider gender concordance at the individual level, and how the distribution of resources across men’s and women’s sports may impact clinical care.