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A Longitudinal Study of Health Care Utilization Among Infants Investigated for Maltreatment
Sarah Vega1, Jeannie S Huang1, Cynthia L Kuelbs1
1Department of Pediatrics, Rady Children's Hospital San Diego (S Vega, JS Huang, and CL Kuelbs), Calif; University of California (S Vega, JS Huang, and CL Kuelbs), San Diego Medical Center.
Insights
Infants investigated for maltreatment experienced significantly more high-acuity healthcare visits in early childhood. This underscores the need for robust medical homes to manage their complex health needs.
Area of Science:
- Pediatric Health
- Child Maltreatment Research
- Healthcare Utilization Studies
Background:
- Child maltreatment, including abuse and neglect, during infancy can have long-term health consequences.
- Understanding the impact of investigated maltreatment on healthcare needs is crucial for early intervention.
Purpose of the Study:
- To determine if maltreatment investigations in infancy influence high-acuity healthcare use in early childhood.
- To quantify the association between infant maltreatment reports and subsequent healthcare utilization.
Main Methods:
- Retrospective case-control study utilizing linked child protection and hospital encounter data.
- Longitudinal follow-up of infants investigated for maltreatment and matched controls for four years from age one.
- Analysis of electronic health records from Rady Children's Hospital.
Main Results:
- A total of 3692 infants were investigated for maltreatment.
- Children with reports of maltreatment in infancy had significantly more high-acuity healthcare encounters compared to controls (Average Treatment Effect = 1.53, P < .001).
- The findings indicate a statistically significant increase in healthcare utilization for maltreated infants.
Conclusions:
- Infants investigated for maltreatment exhibit increased high-acuity healthcare utilization during early childhood.
- This vulnerable population requires well-coordinated medical home services for appropriate care management.
- Further research into the drivers of this increased healthcare burden is recommended to inform support strategies.
Objective:
To evaluate whether maltreatment investigated during infancy affects high-acuity health care utilization patterns during early childhood.
Methods:
Retrospective case-control study based on linked data between child protection and hospital encounter records conducted to review health records of infants investigated for abuse and/or neglect. Cases and controls were followed longitudinally through the Rady Children's Hospital electronic health records for 4 years starting at the age of 1 year.
Results:
A total of 3692 children were investigated for maltreatment within the first year of life. When comparisons were made between children reported for maltreatment and matched controls, children with infancy maltreatment reports had significantly more high-acuity health care encounters than matched controls (average treatment effect = 1.53, 95% Confidence Interval 1.08-1.99, P < .001).
Conclusions:
Infants investigated for maltreatment have greater high-acuity health care utilization in early childhood. These findings highlight this population's need for well-defined medical homes to ensure appropriate health care. Further understanding of the underlying reasons for this increased health care burden will help inform these efforts.
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01:26Longitudinal Studies
02:20Longitudinal Research