Association between missed appointments and hospitalization for child physical abuse

Area of Science:

• Pediatric Medicine
• Child Abuse and Neglect Research
• Healthcare Risk Stratification

Background:

• Child physical abuse (CPA) remains a significant concern, with missed cases persisting despite identified risk factors.
• Previous research has not explored missed medical appointments as a potential risk indicator for CPA.
• Identifying novel risk factors is crucial for improving early detection and intervention strategies for CPA.

Purpose of the Study:

• To investigate the potential association between missed medical appointments and subsequent hospitalization for child physical abuse (CPA).
• To determine if a correlation exists that could aid in identifying children at higher risk for CPA.

Main Methods:

• A 20-year retrospective chart review was conducted within a single health system.
• Hospitalized patients aged 36 months or younger meeting International Classification of Diseases (ICD) criteria for CPA were included.
• Cases of definite or high likelihood CPA were matched (1:5) with control patients based on demographic and clinical factors.

Main Results:

• A significantly higher median proportion of missed appointments was observed in CPA cases (26%) compared to controls (9%) (p < 0.001).
• For every 1% increase in missed appointments, a patient's odds of admission for CPA increased by 3%, even after adjusting for covariates.
• The findings indicate a statistically significant association between missed appointments and CPA hospitalizations.

Conclusions:

• Missed medical appointments are associated with an increased likelihood of hospitalization for child physical abuse (CPA).
• This finding suggests that tracking missed appointments could serve as a valuable tool for clinicians in stratifying CPA risk.
• Further research is warranted, acknowledging limitations such as a single healthcare system and specific case definitions.