Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, CA, United States of America; Kaiser Permanente Bernard J Tyson School of Medicine, Pasadena, CA, United States of America.
Kaiser Permanente Southern California, Department of Research & Evaluation, Pasadena, CA, United States of America.
Child Abuse Negl. 2022 Oct;132:105821. doi: 10.1016/j.chiabu.2022.105821. Epub 2022 Aug 6.
There is limited data regarding the rates and severity of child maltreatment in medical settings during the COVID-19 pandemic, and the reports are somewhat contradictory.
To examine the rates of emergency department (ED) child maltreatment (CM) diagnosis before and after the California statewide stay-at-home order, as well as potential disparities by age, gender, race/ethnicity, and Medicaid status.
A retrospective pre-post interrupted time series was conducted using data from the electronic health records of children (<18 years) with at least one emergency department visit between January 1, 2019 and September 30, 2021. Enactment of the stay-at-home order in California, March 2020 was used to determine a change in trend of rates of diagnosis of CM in the ED.
Overall the study included 407,228 pediatric ED visits. There was a significant change in the percentage of CM visits immediately after the stay-at-home order, followed by small month to month decreases returning to near pre-stay-at-home order levels. This significant increase was driven by higher risk for children <4 years old. The increased rate of CM in the first month after the stay-at-home order was also elevated for female, Black, and Hispanic children.
Our results indicated the rates of CM diagnoses in the ED doubled after the March 2020 stay-at-home order in California. Additionally, our findings suggest that some children may be at higher risk than others, which supports the importance of social safety nets for children in times of national emergency.
在 COVID-19 大流行期间，有关医疗环境中儿童虐待的发生率和严重程度的数据有限，且报告结果有些相互矛盾。
研究加利福尼亚州全州居家令前后急诊部（ED）儿童虐待（CM）诊断的发生率，并按年龄、性别、种族/族裔和医疗补助状况评估潜在差异。
采用电子健康记录中 2019 年 1 月 1 日至 2021 年 9 月 30 日至少有一次急诊就诊的儿童（＜18 岁）的数据，进行回顾性前后交叉时间序列研究。使用加利福尼亚州居家令的颁布（2020 年 3 月）来确定 ED 中 CM 诊断率的趋势变化。
总体上，本研究包括 407228 例儿科 ED 就诊。居家令后 CM 就诊的比例发生了显著变化，随后逐月下降，接近居家令前的水平。这一显著增加是由＜4 岁儿童的风险增加所致。居家令后第一个月 CM 发生率的增加也与女性、黑人以及西班牙裔儿童有关。
我们的研究结果表明，加利福尼亚州 2020 年 3 月居家令后 ED 中 CM 诊断率增加了一倍。此外，我们的研究结果表明，某些儿童可能比其他儿童面临更高的风险，这支持在国家紧急情况下为儿童提供社会安全网的重要性。
