title: Maltreatment-Related Emergency Department Visits Among Children 0 to 3 Years Old in the United States.
abstract: The emergency department (ED) is a vital entry point in the health care system for children who experience maltreatment. This study fills a gap in the maltreatment literature by presenting systematic, national estimates of maltreatment-related ED visits in the United States by children ≤3 years old, from 2006 to 2011, using the Nationwide Emergency Department Sample (NEDS). Children who experienced and likely experienced maltreatment were identified via International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic codes. Maltreatment was classified as physical or sexual abuse, neglect, or poly-victimization. The clinical and demographic profiles of children who experienced maltreatment were described. Approximately 10,095 children who experienced maltreatment (0.1% of total ED visits) and 129,807 children who likely experienced maltreatment (1.2% of total ED visits) were documented each year. Maltreatment was associated with significantly greater risk of injury, hospitalization, and death in the ED setting. Physical abuse was the most common explicit maltreatment diagnosis (33 ED visits per 100,000 children ≤3 years old) and neglect was the most common likely maltreatment diagnosis (436 ED visits per 100,000 children ≤3 years old). This study established the NEDS as a valuable complement to existing surveillance efforts of child maltreatment from a public health perspective.
authors: Center for Health Decision Science, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA aking@hsph.harvard.edu.
authors: Andrew J
authors: AJ
authors: King
authors: Center for Children at Risk, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors: Karen J
authors: KJ
authors: Farst
authors: Pediatric Emergency Medicine, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors: Matthew W
authors: MW
authors: Jaeger
authors: Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors: Jennifer I
authors: JI
authors: Onukwube
authors: Center for Applied Research and Evaluation, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors: James M
authors: JM
authors: Robbins
mesh_terms: D002649:Child Abuse / Q000145:classification / Q000175:diagnosis / Q000706:statistics & numerical data*; D002669:Child Welfare / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009819:Office Visits / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D015599:Trauma Severity Indices; D014481:United States / Q000453:epidemiology
keywords: Public Health; child maltreatment; database review; epidemiology; services utilization (not mental health)
references: BMC Public Health. 2011 Jan 05;11:7
references: 21208410
references: Am J Prev Med. 2004 Dec;27(5):379-84
references: 15556737
references: J Emerg Med. 2002 Nov;23(4):341-5
references: 12480011
references: Arch Pediatr Adolesc Med. 2002 Jan;156(1):73-6
references: 11772194
references: Acad Emerg Med. 2009 Mar;16(3):249-57
references: 19154562
references: Health Serv Res. 2012 Feb;47(1 Pt 1):255-74
references: 22091735
references: J Pediatr. 2009 Feb;154(2):272-7
references: 18822431
references: Pediatr Radiol. 2009 May;39(5):457-60
references: 19198825
references: Pediatrics. 2009 Oct;124(4):1233-43
references: 19770172
references: Pediatrics. 2013 Jun;131(6):e1796-802
references: 23690524
references: Child Abuse Negl. 2011 Jan;35(1):3-17
references: 21316104
references: Obstet Gynecol. 2008 Feb;111(2 Pt 1):423-6
references: 18238982
references: J Trauma. 2004 Jul;57(1):130-40; discussion 140
references: 15284563
references: Child Abuse Negl. 1987;11(2):193-200
references: 3496143
references: BMC Public Health. 2011 Jan 05;11:8
references: 21208411
references: Child Abuse Negl. 2007 Jan;31(1):7-26
references: 17224181
references: Pediatrics. 2005 Aug;116(2):506-12
references: 16061610
references: J Epidemiol Community Health. 2010 Sep;64(9):784-8
references: 19778908
references: Am J Public Health. 2004 Apr;94(4):586-90
references: 15054010
references: Pediatrics. 2007 Jun;119(6):1232-41
references: 17545397
references: Child Abuse Negl. 2014 Jan;38(1):25-36
references: 24094272
references: Lancet. 2009 Jan 3;373(9657):68-81
references: 19056114
references: Child Abuse Negl. 2009 Nov;33(11):791-808
references: 19853915
references: Pediatrics. 2012 Mar;129(3):458-64
references: 22311999
references: Pediatrics. 2008 Sep;122(3):599-604
references: 18762531
references: Child Abuse Negl. 1998 Nov;22(11):1065-78
references: 9827312