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Prevalence of Injuries Among Medicaid Enrolled Infants Prior to Child Abuse and Neglect
Meghan E Shanahan1,2, Anna E Austin1,2, Molly C Berkoff3
1Department of Maternal and Child Health, Gillings School of Global Public Health, 41474University of North Carolina, Chapel Hill, NC, USA.
Insights
Most children diagnosed with maltreatment or injury had prior well-child visits. This suggests healthcare providers can identify and prevent child maltreatment during routine check-ups.
Area of Science:
- Pediatric Health
- Public Health
- Child Maltreatment Research
Background:
- Previous studies on child maltreatment injuries primarily used inpatient data, often excluding neglect cases.
- There's a need to understand injury patterns preceding child maltreatment diagnoses, including neglect.
Purpose of the Study:
- To determine the prevalence of injuries before child maltreatment diagnosis.
- To assess the frequency of well-child visits before injury and maltreatment diagnoses in infants.
Main Methods:
- Secondary analysis of Medicaid data from four states.
- Inclusion of infants with 12 months of continuous enrollment (N=4817).
Main Results:
- 30.6% of infants diagnosed with maltreatment had a prior injury diagnosis.
- 88.4% of maltreated infants had a well-child visit before their maltreatment diagnosis.
- 84% of maltreated infants with prior injuries had a well-child visit before the injury.
Conclusions:
- Most children diagnosed with child maltreatment or associated injuries had preceding well-child visits.
- These findings highlight opportunities for early identification and prevention of child maltreatment within routine pediatric care.
Abstract:
Prior research has identified common injuries among children who experience child maltreatment; however, most of this work has focused on inpatient settings and has excluded many cases of neglect. This study examines the prevalence of injuries that occur prior to a diagnosis of child maltreatment, as well as the proportion of children with well-child visits prior to the injury and child maltreatment diagnosis. Based on a secondary analysis of Medicaid data from four states, we found that among infants with 12 months of continuous enrollment (N = 4817), 30.6% of those diagnosed with maltreatment were previously diagnosed with an injury. Among infants diagnosed with child maltreatment, 88.4% had at least one well-child visit prior to the maltreatment diagnosis. Among children with a maltreatment diagnosis and a prior injury, 84% had at least one well-child visit preceding the injury. These results indicate that most children had at least one well-child visit prior to being diagnosed with child maltreatment or an injury, indicating opportunities for prevention.
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