Division of Paediatric Neurology, Chang Gung Memorial Hospital, Taiwan.
Big Data Research Office, Chang Gung Memorial Hospital, Taiwan.
Child Abuse Negl. 2019 Sep;95:104066. doi: 10.1016/j.chiabu.2019.104066. Epub 2019 Jul 5.
Few studies have examined the effects of the Child Protection Act on child maltreatment in Taiwan.
This study estimated the secular trends in the incidence rate of physical abuse of children requiring hospitalization between 1996 and 2013, and the subsequent in-hospital death proportion before and after implementation of the Act in 2003.
The cases were children younger than 12 years old who were hospitalized due to child abuse, shaken-baby syndrome, neglect, or homicide between 1996 and 2013. A comparison group consisted of children requiring hospitalization for other reasons. We used the National Health Insurance database to identify patients.
The Joinpoint Regression Program was used to estimate temporal trends in the standardized incidence rates.
Between 1996 and 2013, 2050 children required hospitalization for physical abuse. Before 2005, the annual percent change increased by 9.40 [95% confidence interval (CI), 4.98-14.00] per year, and after 2005 the annual percent change was -4.80 (95% CI, -9.53-0.17) per year. Among the 2050 physically abused children requiring hospitalization, 83 (4%) died in hospital. The in-hospital death proportion was 2.62% before 2003 and 4.90% after 2003, and the ratio of these two proportions was 1.43 (95% CI, 0.80-2.58).
The trend in the incidence of hospitalization of children due to physical-abuse-related injuries started to decline 2 years after implementation of the Child Protection Act. However, the proportion of children who died in hospital as a result of physical abuse requiring hospitalization did not change.
鲜有研究调查《儿童保护法》对台湾地区儿童虐待的影响。
本研究旨在评估 1996 年至 2013 年期间因身体虐待而需住院治疗的儿童的发病率的长期趋势，以及 2003 年该法案实施前后因身体虐待而住院的儿童随后的院内死亡率比例。
本研究纳入 1996 年至 2013 年期间因儿童虐待、摇晃婴儿综合征、忽视或杀人而住院的 12 岁以下儿童病例。对照组成员为因其他原因住院的儿童。我们使用国家健康保险数据库识别患者。
使用 Joinpoint 回归程序来估计标准化发病率的时间趋势。
1996 年至 2013 年期间，有 2050 名儿童因身体虐待而需要住院治疗。2005 年前，每年百分比变化增加 9.40（95%置信区间（CI）：4.98-14.00），2005 年后，每年百分比变化为-4.80（95%CI：-9.53-0.17）。在 2050 名需要住院治疗的身体受虐待的儿童中，有 83 名（4%）在医院死亡。2003 年前，院内死亡率为 2.62%，2003 年后为 4.90%，两者比例为 1.43（95%CI：0.80-2.58）。
实施《儿童保护法》两年后，因身体虐待相关伤害而住院的儿童发病率呈下降趋势。然而，因身体虐待而住院的儿童的院内死亡率比例并未改变。
