Imm Pamela, Pac Jessica
Population Health Institute, University of Wisconsin-Madison and Wisconsin Division of Public Health, Madison, Wisconsin (Ms Imm) and Sandra Rosenbaum School of Social Work and Institute for Research on Poverty, University of Wisconsin-Madison, Madison, Wisconsin (Dr Pac).
J Public Health Manag Pract. 2023;29(5):E181-E189. doi: 10.1097/PHH.0000000000001743. Epub 2023 Apr 21.
Child Protective Services (CPS) reports and health records (hospital inpatient and emergency department visits) are the primary data sources to measure child maltreatment; yet, they are not linked at the state or national level. Linking provides novel insight into the demographic characteristics of the populations served by one or both agencies, thus informing opportunities for prevention and intervention.
This study compares children identified as maltreated in health records (based on International Classification of Diseases, Tenth Revision, Clinical Modification [ ICD-10-CM ] codes indicating suspected or confirmed child maltreatment) and/or CPS reports.
Three mutually exclusive comparison groups were created: group 1- children with a nonfatal hospitalization and/or emergency department visit with a maltreatment ICD-10-CM code and an investigated CPS report; group 2- children with a maltreatment ICD-10-CM code in a health record without an investigated CPS report; and group 3- children with an investigated CPS report without a health record with a maltreatment ICD-10-CM code. Descriptive statistics and tests for statistically significant differences were conducted.
Wisconsin children with maltreatment ICD-10-CM code in health record and/or CPS-investigated report from 2018 to 2019.
Demographic and maltreatment type differences between groups.
Group 1 children were significantly younger than those in other groups ( P <. 001), and group 2 children were significantly more female (69.6%; P < .001). Black children were overrepresented in all groups and most disproportionate among group 1 (39.5%; P < .001). Maltreatment type also differed significantly across groups.
CPS staff and health providers encounter overlapping and nonoverlapping populations of children experiencing different types of maltreatment. Although interventions may be tailored toward the type of maltreatment and other relevant child characteristics, all populations could benefit from referrals and access to supportive social services. Agency contact provides an opportunity to intervene and support at-risk children and families.
儿童保护服务（CPS）报告和健康记录（医院住院和急诊科就诊记录）是衡量儿童虐待情况的主要数据来源；然而，在州或国家层面上，它们并未相互关联。将两者关联起来能够为一个或两个机构所服务人群的人口统计学特征提供全新的见解，从而为预防和干预提供机会。
本研究对在健康记录中被认定为受虐待的儿童（基于《国际疾病分类第十次修订本，临床修订版》[ICD - 10 - CM]中表明疑似或确诊儿童虐待的编码）和/或CPS报告中的儿童进行比较。
创建了三个相互排斥的比较组：第1组——因非致命住院和/或急诊科就诊且有虐待相关ICD - 10 - CM编码以及CPS报告被调查的儿童；第2组——健康记录中有虐待相关ICD - 10 - CM编码但无CPS报告被调查的儿童；第3组——有CPS报告被调查但健康记录中无虐待相关ICD - 10 - CM编码的儿童。进行了描述性统计以及统计学显著差异检验。
2018年至2019年期间，威斯康星州健康记录中有虐待相关ICD - 10 - CM编码和/或CPS调查过的报告的儿童。
各比较组之间的人口统计学和虐待类型差异。
第1组儿童明显比其他组儿童年龄小（P <.001），第2组儿童中女性比例明显更高（69.6%；P <.001）。黑人儿童在所有组中占比过高，在第1组中最为突出（39.5%；P <.001）。虐待类型在各组之间也存在显著差异。
CPS工作人员和医疗服务提供者接触到经历不同类型虐待的重叠和非重叠儿童群体。尽管干预措施可能会根据虐待类型和其他相关儿童特征进行调整，但所有群体都可能从转介和获得支持性社会服务中受益。机构间的联系为干预和支持处于危险中的儿童及家庭提供了机会。
