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Published on: January 20, 2023
Health services utilization and cost of abusive head trauma in Taiwan: A population-based retrospective matched
Yi-Ting Chang1, Jui-Ying Feng2, Hsin-Yi Chang1
1Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 70101, Taiwan.
Background:
Abusive head trauma (AHT) is a serious health problem that results the highest mortality among children who are maltreated. Many AHT survivors suffer from long-term sequelae and require medical treatment. However, the knowledge of AHT-attributable health services utilization and costs at national level are limited.
Objective:
To estimate health services utilization and costs attributable to AHT among children aged 0-4 years in Taiwan.
Participants And Setting:
Sixty-three fatal and 664 survival AHT cases were identified using Taiwan national population database between 2003 and 2015. A total of 2656 non-AHT children were exactly 4:1 matched to the survival cases based on their birth year, gender, the calendar year of the index date, insured location, and health insurance premium (social economic status indicator).
Methods:
Health services utilization and costs were calculated on an annual basis for 3 years after the index date. AHT-attributable health services utilization and costs during 3-year follow-up period was evaluated by regression models.
Results:
AHT diagnosis was positively associated with inpatient admissions, length of stay, emergency room (ER) visits, and outpatient visits. AHT-attributable medical costs were 1.64-17.27 times, 1.25-5.22 times, and 1.77-2.36 times greater for inpatient, ER, and outpatient during 3-year period than matched controls, respectively. Fatal AHT cases had higher inpatient utilization and greater medical costs than AHT survivors.
Conclusions:
Children with AHT had greater health services utilization and higher costs for years. Strategies to reduce the burden of AHT on health care system are imperative.
