2011
DOI: 10.1016/j.chiabu.2011.05.016
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Diagnostic coding of abuse related fractures at two children's emergency departments

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Cited by 5 publications
(6 citation statements)
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“…Pediatricians underestimate the rates of maltreated children in their practice 9 and typically do not screen for ACEs, which include maltreatment. 10 Studies comparing documentation rates with maltreatment rates confirmed through other means, such as interdisciplinary review teams, 11-13 caseworker determinations, 14 and independent review of medical records, 15 have demonstrated that most children with confirmed maltreatment are not assigned maltreatment-related codes in medical settings in the United States. Researchers from Taiwan, 16 Australia, 17 and the United Kingdom 18 also report underdocumentation of maltreatment relative to other means of estimating maltreatment rates.…”
mentioning
confidence: 99%
See 1 more Smart Citation
“…Pediatricians underestimate the rates of maltreated children in their practice 9 and typically do not screen for ACEs, which include maltreatment. 10 Studies comparing documentation rates with maltreatment rates confirmed through other means, such as interdisciplinary review teams, 11-13 caseworker determinations, 14 and independent review of medical records, 15 have demonstrated that most children with confirmed maltreatment are not assigned maltreatment-related codes in medical settings in the United States. Researchers from Taiwan, 16 Australia, 17 and the United Kingdom 18 also report underdocumentation of maltreatment relative to other means of estimating maltreatment rates.…”
mentioning
confidence: 99%
“…For example, infants from high-income families are less likely to be diagnosed with maltreatment or followed-up for physical abuse than infants from low-income families, 23-25 and boys are less likely to be ascertained and diagnosed accurately than girls. 11,13,15 Although some studies suggest that maltreatment is less likely to be ascertained 11,15,26 and reported 19,27 for Whites than Blacks, other studies suggest that Black children with confirmed maltreatment are less likely to be assigned an ICD maltreatment code than Whites. 14…”
mentioning
confidence: 99%
“…Further, we saw increased odds of comorbid injuries, such as skull fracture, rib fracture, and head and neck bruising, in children with LBF and ICI, compared with those with only abuse-related LBF. Previous studies have indicated that these comorbid injuries are commonly found in conjunction with AHT, and distinguish AHT from accidental head injury ( 9 , 14 , 15 , 21 , 22 , 23 , 26 ). Our study found that among children with diagnoses of LBF and abuse, additional features of skull fractures, rib fractures, or head and neck bruising also have greater odds of ICI.…”
Section: Discussionmentioning
confidence: 98%
“…Secondly, the population was narrowed down to patients with LBF and abuse. Abuse was classified by ICD-9 diagnosis or external cause of injury codes for physical abuse or assault ( Appendix A ) that have been used in previous publications ( 3 , 21 , 22 , 23 , 24 ). Patients with injuries resulting from motor vehicle accidents were also excluded so that the remaining population presents with a significant injury precipitating LBF without an obvious mechanism.…”
Section: Methodsmentioning
confidence: 99%
“…This study is among the first to evaluate the changes in ICD-10-CM which distinguish confirmed and suspected child maltreatment. Two studies using the Canadian Coding Standards and Canadian Classification of Interventions (ICD-10-CA/CCI) codes evaluated abusive head trauma in children under 3 years of age 25 26. However ICD-10-CA/CA is most comparable to ICD-9-CM, and many codes cannot be directly converted 27 28…”
Section: Discussionmentioning
confidence: 99%