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Trends in hospitalization rates and severity of injuries from abuse in young children, 1997-2009
Karen Farst1, Pratibha B Ambadwar, Andrew J King
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA. kfarst@uams.edu
Insights
Hospitalization rates for child abuse injuries in young children remained stable from 1997 to 2009. However, injury severity scores significantly increased, particularly for infants under one year old.
Area of Science:
- Pediatrics
- Public Health
- Child Maltreatment Research
Background:
- Child abuse and neglect are significant public health concerns.
- Understanding trends in hospitalizations for abusive injuries is crucial for targeted interventions.
- Previous research indicates varying trends in child abuse reporting.
Observation:
- This study analyzed hospitalization data for abusive injuries in children aged 0-3 years from 1997-2009 using the National Inpatient Sample.
- Hospitalization rates for abusive injuries showed no significant change over the study period.
- Infants under one year old experienced higher hospitalization rates and more severe injuries compared to older children.
Findings:
- Hospitalization incidence for abusive injuries remained stable between 1997 and 2009.
- Injury severity scores significantly increased over the study period.
- Younger children (<1 year) had disproportionately higher rates of hospitalization and greater injury severity.
Implications:
- Despite stable hospitalization rates, the increasing severity of injuries suggests a potential worsening of abuse cases.
- Discrepancies between hospitalization data and child welfare reports highlight the need for diverse data sources to accurately track child abuse.
- Findings underscore the critical vulnerability of infants to severe abusive injuries and the need for focused prevention strategies.
Objectives:
To examine trends in incidence of hospitalizations for injury from abuse in young children from 1997 through 2009 and to examine injury severity trends.
Methods:
Cases were identified in the National Inpatient Sample database of the Healthcare Cost and Utilization Project by using International Classification of Diseases, Ninth Revision, Clinical Modification codes for child maltreatment and external cause of injury for assault in children aged 0 through 3 years. Incidence was calculated by age, gender, and region. Trends in incidence of hospitalization and injury severity were calculated over time.
Results:
Hospitalization rates for injury from abuse showed no significant change over the study period, ranging from a low of 2.10 per 10, 000 children in 1998 to a high of 3.01 per 10, 000 children in 2005 (P = .755). Children aged <1 had significantly higher hospitalization rates for injury from abuse (6.01 vs 1.12, P <.001) and higher mean injury severity scores compared with children aged 1 to 3 years (12.50, SD = 0.14 vs 8.56, SD = 0.21, P <.001). Injury severity scores increased significantly over the study period.
Conclusions:
No significant change in hospitalization rates for injury from abuse among young children was observed from 1997 to 2009. These results coincide with other reports of stable or modestly increasing rates of serious physical abuse or death in young children but not with reports from child welfare data showing declines in physical abuse during the same period. Diverse sources of data may provide important complementary methods to track child abuse.
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