Original articlePrediction of Child Abuse Risk from Emergency Department Use
Section snippets
Methods
This population-based case-control study compares ED utilization patterns between Utah-born children with a supported Division of Child and Family Services (DCFS) child abuse report for whom the initial disclosure of abuse occurred between January 1, 2001, and December 31, 2002, and age-matched control subjects. This study was approved by the University of Utah Institutional Review Board and Division of Child and Family Services Institutional Review Board. A Waiver of Informed Consent was
Cases
There were 19 005 children in the state of Utah with supported abuse during the study period. Of these, 52% (n = 9795) met study inclusion criteria. Of those children who were excluded, 46% (n = 4459) were due to age ≥13 years, 40% (n = 3888) for not having a Utah birth record, and 9% (n = 863) for ineligible abuse type.
The majority (79%) of the cases were white, reflecting the general population of Utah (89.2% white),18 58% (n = 5718) had a parent with a valid Utah driver license during the
Discussion
This study has 3 major findings. First, most children with supported abuse are not seen in the ED before the diagnosis of abuse. Specifically, although there is a two times greater number of visits in cases than in control subjects, this only changes the visit rate from a median of 1 to 2 visits before the diagnosis of abuse. In addition, this difference in ED visits decreases even further when stratified by insurance status. Second, most visits occur 1 month or more before the finding of
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Cited by (51)
Caregiver Reports of Infant Distress and Injury in Abused Infants
2022, Journal of PediatricsHealth care utilization pattern prior to maltreatment among children under five years of age in Taiwan
2019, Child Abuse and NeglectCitation Excerpt :Moreover, maltreated children aged 0–12 months had higher number of hospitalizations and children aged 1–5 years with sexual abuse had higher number of outpatient visits with injury diagnosis. Consistent with the findings of previous studies in Utah and Minnesota (Guenther et al., 2009; Karatekin et al., 2018), the study finds that children with maltreatment had higher ED visits than their counterparts without maltreatment, as well as higher number of ED visits with injury-related diagnosis, which was not found by the two previous studies, though. The difference may be attributed to easy access to secondary- and tertiary-level hospitals in Taiwan, which doesn't need copayment for children aged 0–3 years, and convenience for travelling to nearby hospitals.
Child Sexual Abuse identified in Emergency Departments Using ICD-9-CM, 2011 to 2014
2019, Journal of Emergency MedicineCitation Excerpt :Therefore, a victim may visit the ED for either CSA-related or unrelated symptoms and be detected. Individuals with a history of CSA have also been shown to be more likely to use the ED than the general population, suggesting that the ED may be an opportune place to identify current or former victims (45–47). Surveillance in the ED has the potential to address the major limitations of child welfare data, which likely includes only the most severe cases (17,48).
Supported by a National Institutes of Child Health and Human Development (NICHD) grant for Dr. Guenther (K23HD043145). Partial support for all datasets within the Utah Population Database is being provided by the Huntsman Cancer Institute.
The authors declare no potential conflicts of interest.