142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Child Maltreatment in US Emergency Departments: 2006-2011

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Monday, November 17, 2014

Amy Hunter, MPH , Department of Epidemiology, WVU School of Public Health, West Virginia University, Morgantown, WV
Danielle Davidov, PhD , Department of Emergency Medicine, School of Medicine; Department of Social & Behavioral Health Sciences, School of Public Health, West Virginia University, Morgantown, WV
Stephen Davis, MPA, MSW , School of Medicine, Department of Emergency Medicine, West Virginia University, Morgantown, WV
Background: Child maltreatment (CM) is a serious public health concern resulting in acute and long-term negative health consequences. To our knowledge this study is the first describing socio-demographic characteristics of visits coded for CM in the United States (US) using a national database of emergency department (ED) visits.

Methods: This cross-sectional analysis used six years of discharge data (2006-2011) from the Nationwide Emergency Department Sample (NEDS), the largest all-payer ED database in the US, using stratified, multistage sampling to produce national estimates. Frequencies of ED visits for children 0-17 years with at least one of the following codes were abstracted: “Child Abuse”, “Child Sexual Abuse”, “Child Abuse and Neglect”, “Observed Abuse and Neglect”, and “Child Emotional/Psychological Abuse”, and stratified by demographic characteristics.

Result: From 2006-2011, an estimated 102,422 visits (71.05% female) were coded for CM; 6% resulted in admission.  The median age of the sample was 4.38 years. Victims were more likely to live in neighborhood with the lowest median income quartile (< $34,999, 39.74%), receive Medicaid (53.26%), and live in the Midwest and South (66.70%). 60% of CM codes were identified in metropolitan teaching hospitals; 79.85% of all CM codes were identified in urban regions of the country. The total charge for visits resulting in ED discharge was $91,875,066 and $3,009,647 for those admitted.

Conclusion: National data on CM visits seen in US EDs are limited. The current study identifies vast regional differences in CM ED visits previously unreported that warrant further investigation, specifically in the Midwest and South.

Learning Areas:

Other professions or practice related to public health

Learning Objectives:
Identify regional differences in child maltreatment related visits to emergency departments in the US. Describe the socio-demographic characteristics of emergency department visits coded for child maltreatment in the US. Compare the costs of child maltreatment related visits resulting in emergency department discharges with those that were admitted.

Keyword(s): Child Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As a second year doctoral student in epidemiology I have served on several research teams with responsibilities including protocol development, data collection and evaluation. My research is in conjunction with the West Virginia University (WVU) Injury Control Research Center, and the WVU Department of Emergency Medicine with research experts in the areas of intimate partner violence (IPV) and children’s exposure to IPV as a form of child maltreatment. The proposed study builds upon these experiences.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.