Health Gains Planning, Northern Territory Department of Health, Darwin, NT, Australia.
School of Population Health, University of Adelaide, Adelaide, SA, Australia.
Med J Aust. 2014 Aug 4;201(3):162-6. doi: 10.5694/mja14.00015.
To use hospital admissions data to investigate trends in maltreatment among Northern Territory Aboriginal and non-Aboriginal children.
DESIGN, SETTING AND PARTICIPANTS: A historical cohort study using diagnosis and external cause codes from hospital admissions among children aged 0-17 years.
Annual rates of admission with either a definitive or indicative code for child maltreatment.
From 1 January 1999 to 31 December 2010, the average annual rates of hospital admission of NT Aboriginal and non-Aboriginal children with a definitive code of maltreatment were 8.8 (95% CI, 7.4-10.2) and 0.91 (95% CI, 0.59-1.22) per 10 000 children, respectively. There was no evidence for change over time in either population. The corresponding rates of admission with a code indicative of maltreatment were 28.4 (95% CI, 25.8-31.1) and 5.2 (95% CI, 4.4-6.0) per 10 000 children, with average annual increases of 3% (incidence rate ratio [IRR], 1.03; 95% CI, 1.00-1.07) and 4% (IRR, 1.04; 95% CI, 0.96-1.11). Physical abuse was the prominent type of maltreatment-related admission in both populations. There were increases in rates of admission for older Aboriginal children (13-17 years) and older non-Aboriginal boys. Most perpetrators in the assault of younger children were family members, while among older children most were not specified.
Our study shows the utility of hospital admissions for population surveillance of child maltreatment. The relatively stable rate of maltreatment-related hospital admissions among NT Aboriginal children shown here is in contrast to substantial increases reported from child protection data. The results also highlight the overlap between violence within families and in the wider community, particularly for older children, and lends support for population-level interventions to protect vulnerable children.
利用医院入院数据调查北领地原住民和非原住民儿童受虐待的趋势。
设计、设置和参与者:一项历史队列研究,使用儿童(0-17 岁)入院诊断和外部原因代码。
每年因虐待而入院的儿童人数,包括明确或暗示虐待的代码。
从 1999 年 1 月 1 日至 2010 年 12 月 31 日,北领地原住民和非原住民儿童因虐待而住院的平均年率分别为 8.8(95%CI,7.4-10.2)和 0.91(95%CI,0.59-1.22)/10000 名儿童。这两个群体在任何时间都没有证据表明有变化。因虐待而住院的代码指示性的相应比率为 28.4(95%CI,25.8-31.1)和 5.2(95%CI,4.4-6.0)/10000 名儿童,每年平均增长 3%(发病率比 [IRR],1.03;95%CI,1.00-1.07)和 4%(IRR,1.04;95%CI,0.96-1.11)。身体虐待是两个群体中与虐待相关的入院的主要类型。原住民年龄较大的儿童(13-17 岁)和年龄较大的非原住民男孩的入院率有所增加。大多数对年幼儿童的攻击都是家庭成员所为,而对年龄较大的儿童则大多未说明。
我们的研究表明,医院入院情况可用于监测人群中的儿童虐待情况。与从儿童保护数据报告的大量增加形成对比的是,北领地原住民儿童的虐待相关入院率相对稳定。研究结果还突出了家庭内部和更广泛社区内暴力之间的重叠,特别是对年龄较大的儿童,这为保护弱势群体儿童的人群水平干预措施提供了支持。