Using routinely collected hospital data for child maltreatment surveillance: issues, methods and patterns

Area of Science:

• Public Health
• Epidemiology
• Child Health

Background:

• Child maltreatment data often relies on substantiated cases from child protection agencies, underestimating incidence and hindering comparisons.
• Health professionals play a crucial role in identifying, documenting, and reporting suspected child maltreatment.
• Existing morbidity coding systems offer a potential avenue for broader child maltreatment surveillance.

Purpose of the Study:

• To explore the utility of coded morbidity data for identifying and characterizing child maltreatment.
• To outline methods for selecting and grouping relevant diagnostic codes for child maltreatment.
• To illustrate patterns of child maltreatment identified through hospitalisation data.

Main Methods:

• A comprehensive review of the International Classification of Diseases, 10th Revision, Australian Modification (ICD-10-AM) was conducted.
• Codes were categorized into types of maltreatment: physical abuse, sexual abuse, emotional abuse, and neglect.
• Australian hospitalisation data (under 18s) was analyzed to quantify identified cases and explore characteristics.

Main Results:

• Less than 0.5% of hospitalised children had a maltreatment code; higher proportions were found among those with mental/behavioural disorders (4%) or injury/poisoning (1%).
• Patterns varied by sex: physical abuse was most common in males (62.6%), while sexual abuse was most common in females (52.9%).
• Age and sex influenced the types of maltreatment coded.

Conclusions:

• Hospitalisation data offers a valuable resource for routine child maltreatment monitoring and surveillance.
• Enhanced utilization of routinely collected national data can strengthen the evidence base for child protection.
• This approach is crucial for informing public health responses to child maltreatment, especially where linked data is unavailable.