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与虐待儿童相关的伤害:发病率、住院费用及住院相关因素

Child maltreatment related injuries: incidence, hospital charges, and correlates of hospitalization.

作者信息

Forjuoh S N

机构信息

Department of Family Medicine, Scott & White Memorial Hospital and Clinic, Scott, Sherwood and Brindley Foundation, Texas A&M University System Health Science Center, College of Medicine, Temple, USA.

出版信息

Child Abuse Negl. 2000 Aug;24(8):1019-25. doi: 10.1016/s0145-2134(00)00163-0.

Abstract

OBJECTIVE

This study was undertaken to determine the incidence, hospital charges, and correlates associated with inpatient treatment of child maltreatment related injuries.

METHODS

The data were based on the 1995 Pennsylvania Hospital Discharge Data which included all Pennsylvania acute care hospitals that reported child maltreatment discharges. Per capita hospital discharge rates were computed for children discharged with child maltreatment related injuries according to selected variables. Odds ratios for child maltreatment related injury hospitalizations were also computed.

RESULTS

A total of 348 maltreated injured children ages 0-19 years were discharged from Pennsylvania hospitals in 1995, representing an incidence rate of 10.8 per 100,000 persons. The total hospital charges for child maltreatment related injury discharges amounted to over $5.4 million, of which Medicaid alone paid for 45%. Compared to a random sample of non-maltreated injured children (n = 1052), maltreated injured children were found to be significantly younger, more likely to be females, and more likely to be Black. Child maltreatment related injury hospitalizations were more likely to be urgent and via physician referral or transfer from other health care facility. Maltreated injured children were three times as likely to die as other children.

CONCLUSIONS

These findings indicate that injury from child maltreatment is a major cause of hospitalization of young children 5 years and younger and represents a significant cost to publicly financed health care. While hospital discharge data can be used for population-based surveillance of child maltreatment related trauma, there is need for improvement in the surveillance of these injuries.

摘要

目的

本研究旨在确定与虐待儿童相关伤害的住院治疗相关的发病率、住院费用及相关因素。

方法

数据基于1995年宾夕法尼亚州医院出院数据,其中包括所有报告有虐待儿童出院情况的宾夕法尼亚州急症护理医院。根据选定变量计算因虐待儿童相关伤害出院的儿童的人均出院率。还计算了虐待儿童相关伤害住院的比值比。

结果

1995年,共有348名年龄在0至19岁之间受虐待受伤的儿童从宾夕法尼亚州医院出院,发病率为每10万人中有10.8例。虐待儿童相关伤害出院的总住院费用超过540万美元,其中仅医疗补助就支付了45%。与随机抽取的未受虐待受伤儿童样本(n = 1052)相比,受虐待受伤儿童明显更年幼,更可能为女性,且更可能为黑人。虐待儿童相关伤害的住院更可能是紧急情况,且是通过医生转诊或从其他医疗机构转来的。受虐待受伤儿童死亡的可能性是其他儿童的三倍。

结论

这些发现表明,虐待儿童造成的伤害是5岁及以下幼儿住院的主要原因,对公共资助的医疗保健构成重大成本。虽然医院出院数据可用于对虐待儿童相关创伤进行基于人群的监测,但仍需改进对这些伤害的监测。

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