Using Routinely Collected Hospital Data for Child Maltreatment Surveillance: Issues, Methods and Patterns
Using Routinely Collected Hospital Data for Child Maltreatment Surveillance: Issues, Methods and Patterns
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DOI：
10.1186/1471-2458-11-7
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发表时间：
2011-01-05
影响因子：
4.5
通讯作者：
Scott, Debbie A.
中科院分区：
文献类型：
--
作者：
McKenzie, Kirsten;Scott, Debbie A.
背景：有关虐待儿童的国际数据主要来自儿童保护机构，而且主要只报告得到证实的虐待儿童案件。这种做法低估了虐待的发生率，并使司法管辖区之间的比较变得困难。越来越多的人认识到卫生专业人员在查明、记录和报告涉嫌虐待儿童方面的重要性。本研究旨在描述使用编码发病率数据进行病例识别的相关问题，概述相关编码的选择和分组的方法，并说明识别的虐待模式。方法：对ICD-10-AM分类系统进行全面回顾，包括对索引词的回顾、表格卷的自由文本检索以及与儿童虐待编码相关的编码标准的综述。已识别的代码被进一步分类为虐待类型，包括身体虐待、性虐待、情感或心理虐待以及疏忽。结果：2005-2006年间，在澳大利亚住院的儿童中，只有不到0.5%的儿童被分配了虐待代码，近4%的主要诊断为精神和行为障碍的儿童和超过1%的主要诊断为伤害或中毒的儿童被分配了虐待代码。被分配有明确T74编码的儿童的模式因性别和年龄组而异。对于被选为有虐待相关表现的男性，身体虐待是最常见的编码(62.6%的虐待案例)，而对于被选为有虐待相关表现的女性，性虐待是最常见的虐待形式(52.9%的虐待案例)。结论：这项研究表明，即使没有基于人口的相关数据源，医院数据也可以为儿童虐待的常规监测和监测提供有价值的信息。随着国家和国际呼吁对虐待儿童采取公共卫生对策，更好地了解、投资和利用我们国家例行收集的核心数据来源，将加强支持对处于危险中的儿童采取适当对策所需的证据基础。
Background: International data on child maltreatment are largely derived from child protection agencies, and predominantly report only substantiated cases of child maltreatment. This approach underestimates the incidence of maltreatment and makes inter-jurisdictional comparisons difficult. There has been a growing recognition of the importance of health professionals in identifying, documenting and reporting suspected child maltreatment. This study aimed to describe the issues around case identification using coded morbidity data, outline methods for selecting and grouping relevant codes, and illustrate patterns of maltreatment identified.Methods: A comprehensive review of the ICD-10-AM classification system was undertaken, including review of index terms, a free text search of tabular volumes, and a review of coding standards pertaining to child maltreatment coding. Identified codes were further categorised into maltreatment types including physical abuse, sexual abuse, emotional or psychological abuse, and neglect. Using these code groupings, one year of Australian hospitalisation data for children under 18 years of age was examined to quantify the proportion of patients identified and to explore the characteristics of cases assigned maltreatment-related codes.Results: Less than 0.5% of children hospitalised in Australia between 2005 and 2006 had a maltreatment code assigned, almost 4% of children with a principal diagnosis of a mental and behavioural disorder and over 1% of children with an injury or poisoning as the principal diagnosis had a maltreatment code assigned. The patterns of children assigned with definitive T74 codes varied by sex and age group. For males selected as having a maltreatment-related presentation, physical abuse was most commonly coded (62.6% of maltreatment cases) while for females selected as having a maltreatment-related presentation, sexual abuse was the most commonly assigned form of maltreatment (52.9% of maltreatment cases).Conclusion: This study has demonstrated that hospital data could provide valuable information for routine monitoring and surveillance of child maltreatment, even in the absence of population-based linked data sources. With national and international calls for a public health response to child maltreatment, better understanding of, investment in and utilisation of our core national routinely collected data sources will enhance the evidence-base needed to support an appropriate response to children at risk.