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Recurrent early childhood injuries among disadvantaged children in primary care settings
P A Braun1, B L Beaty, C DiGuiseppi
1Department of Community Health Services, Denver Health, 501 28th Street, Denver, CO 80205, USA. patricia.braun@uchsc.edu
Insights
Children with recurrent injuries often face social risk factors and utilize healthcare services more frequently. Identifying these risk factors allows for targeted injury prevention counseling during healthcare visits.
Area of Science:
- Pediatric health outcomes
- Social determinants of health
- Injury prevention
Background:
- Recurrent injuries in young children are a significant public health concern.
- Understanding associated social risk factors is crucial for effective intervention.
- Healthcare utilization patterns can provide insights into injury risk.
Purpose of the Study:
- To investigate the relationship between social risk factors and recurrent injuries in young children.
- To compare healthcare utilization among children with no, one, or multiple injury episodes.
- To identify specific social risk factors associated with recurrent childhood injuries.
Main Methods:
- Retrospective cohort study utilizing administrative claims and medical records.
- Analysis of children born at Denver Health Medical Center (DHMC) from 1993 to 36 months of age.
- Comparison of sociodemographic information, service use, and injury data.
Main Results:
- Children with recurrent injuries ( >1 episode) were more likely to have social risk factors (78%) compared to those with one (63%) or no injuries (52%).
- Maternal substance abuse, young maternal age, single or mentally ill caregivers, and family violence history were significant risk factors for recurrent injuries.
- Recurrent injuries correlated with increased use of primary care, emergency department visits, and overall healthcare encounters.
Conclusions:
- Young children experiencing recurrent injuries are disproportionately affected by social risk factors.
- These children exhibit higher healthcare service utilization, indicating a need for integrated support.
- Early identification of at-risk families enables targeted injury prevention counseling within healthcare systems.
Objective:
To examine differences in social risk factors and health care use between young children with and without recurrent injuries.
Design:
Retrospective cohort study using administrative claims and medical records. Children with no, one, or more than one injury were compared.
Setting:
Integrated public healthcare system.
Subjects:
All children born at Denver Health Medical Center (DHMC) in 1993 who continued care there beyond 15 months of age. Children were followed to 36 months.
Outcome Measures:
Sociodemographic information, service use, injury episodes, cause of injury, and social risk factors.
Results:
371 injury episodes occurred among 817 children. In the study cohort, 7% had >1 injury episode, 26% had one injury, and 67% had none. Among children with >1 injury episode, 78% had at least one social risk factor compared with 63% of children with one injury and 52% of children with none (p<0.0001). Risk factors for >1 injury included maternal substance abuse (p = 0.0003), maternal age under 18 years (p = 0.04), a primary caregiver who was single (p<0.0001) or mentally ill (p = 0.03), and a history of family violence (p = 0.01). Multiple injury episodes were associated with increased non-injury service use, including primary care visits (p<0.0001), emergency department visits (p<0.0001), and total non-injury encounters (p<0.0001).
Conclusions:
Children with recurrent injury were more likely to have social risk factors, and used DHMC more frequently, than children with one or no injuries. Children with risk factors for recurrent injury can be identified and injury prevention counseling can be delivered to their families at their multiple visits to the system.
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