Key Factors for Providing Appropriate Medical Care in Secondary School Athletics: Athletic Training Services and Budget (Original Research) (Report‪)‬

Injuries sustained by high school athletes are a well-established public health problem, with numerous authors (1-9) reporting that injuries occur in all sports, at all competition levels, in both sexes, and during both games and practices. Most recent estimates indicate that more than 1.4 million high school injuries occur each year in the United States. (10) Despite widespread acknowledgment of this problem, questions regarding the availability of appropriate medical care for high school athletics have persisted for many years. Beginning in the 1970s, concern about the quality and availability of the medical care afforded high school athletes began to receive attention. (11-13) Over the past 30 years, more than 20 research studies have examined some aspect of medical care provided to high school athletes in 15 states, including South Carolina, (14,15) North Carolina, (16) California, (17) Michigan, (18,19) New York, (20) Illinois, (21-23) Wisconsin, (24) Maryland, (25) Alabama, (26-28) Louisiana, (29) Conneticut, (30) Iowa, (31) Virginia, (32) Hawaii, (5,33) and Indiana. (34) However, these studies offer only a limited understanding of medical care for high school athletes, because the authors focused on medical coverage, primarily for varsity football games, with no assessment of the comprehensive health care provided for an entire athletics program during both practices and competitions. As early as 1985, Cartland (30) suggested the need for established, standardized guidelines to identify minimal standards for the prevention and care of athletic injuries. Finally, in 2002, the "Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement" (35) was created to provide standardized guidelines for appropriate medical care for high school athletics. The AMCSSAA consensus statement was developed by an interassociation task force with representatives from 17 professional organizations related to health care, athletics, and secondary school administration, including the National Athletic Trainers' Association, the American Academy of Orthopaedic Surgeons, the National Association of Secondary School Principals, and the National Federation of State High School Associations. The document established recommendations for the prevention, care, and appropriate management of injuries and illnesses specific to the secondary school aged athlete. It recognized that appropriate care encompasses ongoing daily heath care, not merely emergency care during games. The consensus statement called for the establishment of an athletic health care team for every American high school athletics program consisting of a variety of health care providers with a designated health care provider who is trained to (35)