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COVID-19 大流行前后诊断为儿童虐待的病例和儿童保护报告。

Counts and child protection reports of diagnosed child maltreatment before and after the COVID-19 pandemic onset.

机构信息

University of North Carolina at Chapel Hill School of Social Work, 325 Pittsboro St, Chapel Hill, NC 27599, USA.

University of North Carolina at Chapel Hill School of Public Health, 135 Dauer Drive, Chapel Hill, NC 27599, USA.

出版信息

Child Abuse Negl. 2023 Dec;146:106450. doi: 10.1016/j.chiabu.2023.106450. Epub 2023 Sep 13.

Abstract

BACKGROUND

Mechanisms for reporting child maltreatment (CM) were affected by changes in service provision immediately following the onset of the COVID-19 pandemic.

OBJECTIVE

To examine changes in counts and CPS reporting of CM medical encounters before and after the onset of COVID-19.

PARTICIPANTS AND SETTING

All emergency department and inpatient medical encounters with at least one CM diagnosis during the study period at Rady Children's Hospital San Diego, the largest pediatric hospital in California between 2016 and November 2021.

METHODS

Using linked medical record and CPS administrative data, interrupted time series models tested for changes in monthly counts and percentages of CM medical encounters reported to CPS with the onset of COVID-19. Logistic regression tested for the likelihood of a CPS report being associated with a CM encounter.

RESULTS

CM medical encounters totaled 2528, including 793 after the onset of COVID-19. Interrupted time series models indicated with the onset of the pandemic, the counts of CM encounters increased 18 % (RR: 1.18, 95 % CI 1.03-1.34) and the percentages reported to CPS increased 10 % (RR: 1.10, 95 % CI: 1.05-1.17). CM encounters that occurred after the onset of the COVID-19 pandemic had increased odds of a CPS report (fully adjusted model: OR: 1.08; 95 % CI: 1.05-1.12).

CONCLUSIONS

This study found increases in monthly counts and a higher percentage of CM medical encounters with CPS reports after the pandemic onset.

摘要

背景

儿童虐待(CM)报告机制受到 COVID-19 大流行开始后服务提供变化的影响。

目的

研究 COVID-19 大流行前后 CM 医疗就诊的计数和 CPS 报告变化。

参与者和设置

2016 年至 2021 年 11 月期间,加利福尼亚最大的儿科医院圣地亚哥 Rady 儿童医院所有至少有一个 CM 诊断的急诊和住院医疗就诊。

方法

使用链接的医疗记录和 CPS 行政数据,中断时间序列模型测试了 COVID-19 大流行开始时每月 CM 医疗就诊计数和向 CPS 报告的百分比的变化。逻辑回归测试了 CPS 报告与 CM 就诊相关的可能性。

结果

CM 医疗就诊共 2528 例,其中 COVID-19 大流行后有 793 例。中断时间序列模型表明,随着大流行的开始,CM 就诊的数量增加了 18%(RR:1.18,95%CI 1.03-1.34),向 CPS 报告的百分比增加了 10%(RR:1.10,95%CI:1.05-1.17)。COVID-19 大流行后发生的 CM 就诊向 CPS 报告的可能性增加(完全调整模型:OR:1.08;95%CI:1.05-1.12)。

结论

本研究发现,大流行后 CM 医疗就诊的每月计数增加,向 CPS 报告的比例更高。

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