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Health care utilization pattern prior to maltreatment among children under five years of age in Taiwan
Liang-Yi Wang1, Chih-Ying Wu1, Yi-Hsin Chang1
1Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Insights
Children experiencing maltreatment show increased emergency department visits and hospitalizations. Recognizing these healthcare patterns aids in early identification of at-risk children.
Area of Science:
- Pediatric Healthcare Utilization
- Child Maltreatment Research
- Public Health Surveillance
Background:
- Inconsistent findings exist regarding healthcare utilization patterns in maltreated children.
- Previous studies suggest differences in healthcare use between maltreated and non-maltreated children.
Purpose of the Study:
- To investigate differences in healthcare utilization among children aged 0-5 with maltreatment in Taiwan.
- To compare healthcare access patterns between maltreated children and their non-maltreated peers.
Main Methods:
- Population-based, case-controlled study in Taiwan (2007-2013).
- Included children born in 2007 with maltreatment diagnoses (cases) and matched controls.
- Analyzed outpatient visits, emergency department (ED) visits, and hospitalizations, adjusting for covariates.
Main Results:
- Maltreated children had significantly higher rates of ED visits (aOR 3.52 for injury-related, aOR 2.00 for non-injury-related).
- Increased hospitalizations were observed in maltreated children, particularly for non-injury-related reasons (aOR 2.47 for two or more).
Conclusions:
- Child maltreatment is associated with elevated ED visits and hospitalizations.
- Monitoring healthcare utilization can facilitate early detection of children at risk for maltreatment.
Background:
Several studies have hypothesized that the pattern of health care utilization among maltreated children differ from others without the experience. However, the conclusions have not been consistent.
Objective:
The study aims to examine whether the pattern of health care utilization among children 0-5 years old with maltreatment different from their counterparts without maltreatment in Taiwan.
Subjects And Setting:
All children born in 2007 in Taiwan.
Method:
This is a population-based and case-controlled study. Cases are children under five years of ago with maltreatment-related diagnosis in the claims data of the National Health Insurance in Taiwan during the 2007-2013 period. For each case, there were 10 birth date-matched controls. Exposure variables include the number of injury or non-injury-related outpatients, emergency department (ED) visits, and hospitalization. Multivariate models were employed, with adjustment for sex, urbanization level, and comorbidities of children.
Results:
Of children born in 2007, 382 had maltreatment-related diagnosis during the age of 0-5. The adjusted odds ratio (aOR) for having two or more ED visits with or without injury-related diagnosis is 3.52 (95% CI 1.75-7.07) and 2.0-0 (95% CI 1.47-2.72), respectively. Children with maltreatment also had significantly higher number of hospitalization without injury-related diagnosis and aOR for those having two more hospitalizations stands at 2.47 (95% CI 1.59-3.83).
Conclusions:
Children with maltreatment when 0-5 years old had higher number of ED visits with injury-related diagnosis, as well as hospitalization without injury-related diagnosis. Recognition of the health care utilization is conducive to early identification of children with risk for maltreatment.
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