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American Academy of Pediatrics
Article

Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009

Karen Farst, Pratibha B. Ambadwar, Andrew J. King, T. M. Bird and James M. Robbins
Pediatrics June 2013, 131 (6) e1796-e1802; DOI: https://doi.org/10.1542/peds.2012-1464
Karen Farst
aSection for Children at Risk and
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Pratibha B. Ambadwar
bCenter for Applied Research and Evaluation, Department of Pediatrics, and
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Andrew J. King
bCenter for Applied Research and Evaluation, Department of Pediatrics, and
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T. M. Bird
cDepartment of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
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James M. Robbins
bCenter for Applied Research and Evaluation, Department of Pediatrics, and
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Abstract

OBJECTIVES: To examine trends in incidence of hospitalizations for injury from abuse in young children from 1997 through 2009 and to examine injury severity trends.

METHODS: Cases were identified in the National Inpatient Sample database of the Healthcare Cost and Utilization Project by using International Classification of Diseases, Ninth Revision, Clinical Modification codes for child maltreatment and external cause of injury for assault in children aged 0 through 3 years. Incidence was calculated by age, gender, and region. Trends in incidence of hospitalization and injury severity were calculated over time.

RESULTS: Hospitalization rates for injury from abuse showed no significant change over the study period, ranging from a low of 2.10 per 10 000 children in 1998 to a high of 3.01 per 10 000 children in 2005 (P = .755). Children aged <1 had significantly higher hospitalization rates for injury from abuse (6.01 vs 1.12, P <.001) and higher mean injury severity scores compared with children aged 1 to 3 years (12.50, SD = 0.14 vs 8.56, SD = 0.21, P <.001). Injury severity scores increased significantly over the study period.

CONCLUSIONS: No significant change in hospitalization rates for injury from abuse among young children was observed from 1997 to 2009. These results coincide with other reports of stable or modestly increasing rates of serious physical abuse or death in young children but not with reports from child welfare data showing declines in physical abuse during the same period. Diverse sources of data may provide important complementary methods to track child abuse.

  • injury
  • maltreatment
  • child abuse
  • health policy
  • Abbreviations:
    AIS —
    abbreviated injury severity score
    aOR —
    adjusted odds ratio
    CI —
    confidence interval
    HCUP —
    Healthcare Cost and Utilization Project
    ICD-9-CM —
    International Classification of Diseases, Ninth Revision, Clinical Modification
    ISS —
    injury severity score
    KID —
    Kids’ Inpatient Database
    NCANDS —
    National Child Abuse and Neglect Data System
    NIS —
    Nationwide Inpatient Sample
    • Accepted February 26, 2013.
    • Copyright © 2013 by the American Academy of Pediatrics

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    Pediatrics
    Vol. 131, Issue 6
    1 Jun 2013
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    Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009
    Karen Farst, Pratibha B. Ambadwar, Andrew J. King, T. M. Bird, James M. Robbins
    Pediatrics Jun 2013, 131 (6) e1796-e1802; DOI: 10.1542/peds.2012-1464

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    Trends in Hospitalization Rates and Severity of Injuries From Abuse in Young Children, 1997–2009
    Karen Farst, Pratibha B. Ambadwar, Andrew J. King, T. M. Bird, James M. Robbins
    Pediatrics Jun 2013, 131 (6) e1796-e1802; DOI: 10.1542/peds.2012-1464
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