5262.0: Wednesday, November 15, 2000 - Board 11

Abstract #14546

Utilizing the FIMR model to implement county-wide review of all child deaths

Cindie Carroll-Pankhurst, PhD, MPA1, Heather Pierce, LSW2, Darry Draper, BS2, and Mary E. O'Connor, MD, MPH3. (1) Mandel School of Applied Social Sciences, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-4945, (2) Cuyahoga County Board of Health, (3) Medical Dirctor, Cuyahoga County Board of Health, 1375 Euclid Ave, Cleveland, OH 44115-1882, 216 443 6698, meo@po.cwru.edu

The Random Case Review Subcommittee of the Cuyahoga County Child Death Review Steering Committee (CDR) conducted comprehensive case reviews of child deaths within the county. The case reviews included medical record abstraction and interviews with parents to assess significant social, economic, cultural, safety and health system factors associated with child mortality. Structured interviews used a modified FIMR format. The case review team identified contributing and non-contributing issues related to the child death, as well as strengths in the delivery of services, to plan interventions and policies that address these issues. In 1999, 205 deaths were recorded. Reviews were completed for 52 cases, 27 families declined to participate, 59 did not respond to repeated attempts to contact them (telephone, letter and home visits), 20 had moved, 12 were still pending an investigation, and 35 were still open with attempts to contact. The respondent families were found to be representative of all cases, with slight, but non-significant, over representation of cases with birth defects and unusual medical conditions. The cases reviewed were infants - 62%, children 1 - 9 years - 21%, and children 10 and 17 years - 17%. Males made up 56%. Prematurity (35%) was the leading cause of death followed by birth defects (23%). The reviews generated 71 recommendations to the CDR in the following areas: 37 community/parent education, 25 policy, and 9 provider/systems. All recommendations promote effective changes in community resources and services available to families, and are incorporated in the CDR annual report.

Learning Objectives: At the end of this session, participants will be able to discuss the advantages of incorporating fetal and infant mortality review methods in evaluating all child deaths

Keywords: Child Health, Death

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA