Variation in recorded child maltreatment concerns in UK primary care records: a cohort study using The Health Improvement Network (THIN) database.
Variation in recorded child maltreatment concerns in UK primary care records: a cohort study using The Health Improvement Network (THIN) database.
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DOI：
10.1371/journal.pone.0049808
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发表时间：
2012
期刊：
影响因子：
3.7
通讯作者：
Petersen I
中科院分区：
文献类型：
--
作者：
Woodman J;Freemantle N;Allister J;de Lusignan S;Gilbert R;Petersen I
确定儿童初级保健记录中与虐待和忽视（虐待）相关的问题记录随时间和做法的变化。使用英国代表性初级保健数据库进行回顾性队列研究。 448 一般做法。 1995 年至 2010 年间，共有 1,548 名儿童（<18 岁）登记。每个儿童登记年份的一个或多个虐待相关代码的年发生率变化。一般做法之间的差异以 3 年（2008 年至 2010 年）期间具有一项或多项虐待相关代码的登记儿童的比例来衡量。从 1995 年到 2010 年，任何编码的虐待相关问题的年发生率每年上升 10.8%（95% 置信区间 10.5、11.2；根据性别、年龄和贫困情况进行调整）。 2010 年，该比率为每 1000 名儿童年 9.5 例（95%CI：9.3、9.8），相当于 2010 年所有登记儿童的患病率为 0.8%。在所有实践中，三年（2008 年至 2010 年）中具有任何虐待相关代码的儿童的中位患病率是 0.9%（范围 0%–13.4%；11 个实践） （2.5%）同期有相关代码的孩子为零）。一旦我们考虑了性别、年龄和贫困，每种做法的流行率都在总平均值的两个标准误差以内。全科医生 (GP) 远未脱离保护儿童的职责；他们持续且越来越多地记录虐待问题。由于这些结果可能低估了初级保健已知的虐待负担，因此初级保健记录中的记录有很大的增加空间，这对应对虐待问题的资源产生了影响。干预措施和政策应建立在英国普通全科医生参与儿童保护活动的证据之上。
To determine variation over time and between practices in recording of concerns related to abuse and neglect (maltreatment) in children's primary care records. Retrospective cohort study using a United Kingdom representative primary care database. 448 General Practices. In total 1,548, 972 children (<18 y) registered between 1995 and 2010. Change in annual incidence of one or more maltreatment-related codes per child year of registration. Variation between general practices measured as the proportion of registered children with one or more maltreatment-related codes during 3 years (2008–2010). From 1995–2010, annual incidence rates of any coded maltreatment-related concerns rose by 10.8% each year (95% confidence interval 10.5, 11.2; adjusted for sex, age and deprivation). In 2010 the rate was 9.5 per 1000 child years (95%CI: 9.3, 9.8), equivalent to a prevalence of 0.8% of all registered children in 2010. Across all practices, the median prevalence of children with any maltreatment-related codes in three years (2008 to 2010) was 0.9% (range 0%–13.4%; 11 practices (2.5%) had zero children with relevant codes in the same period). Once we accounted for sex, age, and deprivation, the prevalence for each practice was within two standard errors of the grand mean. General Practitioners (GPs) are far from disengaged from safeguarding children; they are consistently and increasingly recording maltreatment concerns. As these results are likely to underestimate the burden of maltreatment known to primary care, there is much scope for increasing recording in primary care records with implications for resources to respond to concerns about maltreatment. Interventions and policies should build on this evidence that the average GP in the UK is engaged in child safeguarding activity.
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影响因子：
8
作者：
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