National Trends in Emergency Department Visits for Child Maltreatment, 2007–2014

Abstract

Objective: To understand the prevalence of child maltreatment-related emergency department (ED) visits in the United States, we examined data from the 2007 to 2014 Nationwide Emergency Department Sample.Methods: Based on existing literature, International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9 CM) ED discharge codes for children less than 10 years of age were characterized as specified child maltreatment, defined as visits with an explicit maltreatment ICD-9 CM or external causes of injury codes. The prevalence of child maltreatment visits per 100,000 children in the United States (based on Center for Disease Control Wide-ranging ONline Data for Epidemiologic Research estimates) overall and by sociodemographic factors was examined, and tests for trends over time were evaluated with Cochran-Armitage tests. Analyses were conducted in 2019. Results:The prevalence of child maltreatment based in ICD-9 CM discharge codes ED visits dropped from 69.2 visits per 100,000 in 2007 to 65.9 visits per 100,000 in 2014; this trend was statistically significant. The prevalence was lowest in 2010 (60.1 visits per 100,000 children). There were increases observed for some demographic groups in this period. Throughout the 8-year period examined, the prevalence of child maltreatment visits was highest for physical abuse compared with other forms of maltreatment, higher for boys compared with girls; highest for children younger than 1 year, and higher for children living in neighborhoods with the lowest median income compared with children in higherincome neighborhoods. Conclusions:The Nationwide Emergency Department Sample data set is a valuable surveillance tool for examining trends in child maltreatment. Future studies should explore what factors may explain variations in child maltreatment over time to best develop prevention strategies.

Associations between nurse characteristics, institutional characteristics and perceived nurse knowledge and self‐efficacy of reporting suspected child abuse and neglect

“…Like paediatric nurses, ED nurses may have more contact with children, youth and families, and more opportunity to assess for CAN as part of their everyday workload. Children, youth, families and caregivers present to the ED for several reasons including concerns of or experiencing child maltreatment (Suglia et al., 2022), and ED nurses will likely be in contact with patients that have encountered violence and abuse (Wolf et al., 2022). Hence, the ED becomes a necessary place for mandated reporters and healthcare providers to identify and report suspicion of CAN (Filmalter et al., 2018).…”

“…While this study was for all nurses from diverse settings, nurse education and practices, there was an interest in the findings from forensic, paediatric and ED nurses in hospital/acute care settings to understand the institutional facilitators to responding to CAN. and caregivers present to the ED for several reasons including concerns of or experiencing child maltreatment (Suglia et al, 2022), and ED nurses will likely be in contact with patients that have encountered violence and abuse (Wolf et al, 2022). Hence, the ED becomes a necessary place for mandated reporters and healthcare providers to identify and report suspicion of CAN (Filmalter et al, 2018).…”

Risk of Injury-Related Readmission Varies by Initial Presenting-Hospital Type Among Children at High Risk for Physical Abuse

“…[23][24][25] This study used a broadly inclusive definition of HRCPA to capture all patients at risk, an approach that has been used in recent studies. 26,27 Other studies suggest that the level of verification of a trauma center influences the ability to recognize and document CPA. 9 To our knowledge, this is the first study to investigate initial presenting-hospital type and its association with risk of subsequent admission in a state-level cohort using broadly inclusive criteria for HRCPA.…”

“…Previous studies of CPA among children presenting to medical facilities report widely varying prevalence rates of less than 0.1% to more than 10%, depending on the population studied, the intensity of screening, and definition of child abuse risk 23–25 . This study used a broadly inclusive definition of HRCPA to capture all patients at risk, an approach that has been used in recent studies 26,27 . Other studies suggest that the level of verification of a trauma center influences the ability to recognize and document CPA 9 …”