RT Journal Article
SR Electronic
T1 Child maltreatment surveillance following the ICD-10-CM transition, 2016-2018
JF Injury Prevention
JO Inj Prev
FD BMJ Publishing Group Ltd
SP 251
OP 256
DO 10.1136/injuryprev-2019-043579
VO 27
IS 3
A1 Amy A Hunter
A1 Nina Livingston
A1 Susan DiVietro
A1 Laura Schwab Reese
A1 Kathryn Bentivegna
A1 Bruce Bernstein
YR 2021
UL http://injuryprevention.bmj.com/content/27/3/251.abstract
AB Background Child maltreatment is poorly documented in clinical data. The International Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification (ICD-10-CM) represents the first time that confirmed and suspected child maltreatment can be distinguished in medical coding. The utility of this distinction in practice remains unknown. This study aims to evaluate the application of these codes by patient demographic characteristics and injury type.Methods We conducted secondary data analysis of emergency department (ED) discharge records of children under 18 years with an ICD-10-CM code for confirmed (T74) or suspected (T76) child maltreatment. Child age, sex, race/ethnicity, insurance status and co-occurring injuries (S00-T88) were compared by maltreatment type (confirmed or suspected).Results From 2016 to 2018, child maltreatment was documented in 1650 unique ED visits, or 21.7 per 10 000 child ED visits. Suspected maltreatment was documented most frequently (58%). Half of all maltreatment-related visits involved sexual abuse, most often in females and individuals of non-Hispanic white race. Physical abuse was coded in 36% of visits; injuries to the head were predominant. Non-Hispanic black children were more frequently documented with confirmed physical abuse than suspected (38.7% vs 23.7%, p<0.01). The rate of co-occurring injuries documented with confirmed and suspected maltreatment differed by 30% (9.2 vs 12.5 per 10 000 ED visits, respectively).Conclusions The ability to discriminate confirmed and suspected maltreatment may help mitigate clinical barriers to maltreatment surveillance associated with delayed diagnosis and subsequent intervention. Racial disparities in suspected and confirmed cases were identified which may indicate biased diagnostic behaviours in the ED.Data may be obtained from a third party and are not publicly available. Data for this analysis were obtained from the Connecticut Hospital Association and may be available upon request.