Child maltreatment surveillance following the ICD-10-CM transition, 2016-2018
Child maltreatment surveillance following the ICD-10-CM transition, 2016-2018
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DOI：
10.1136/injuryprev-2019-043579
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发表时间：
2021-06-01
影响因子：
3.7
通讯作者：
Bernstein, Bruce
中科院分区：
文献类型：
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作者：
Hunter, Amy A.;Livingston, Nina;Bernstein, Bruce
背景：儿童虐待在临床资料中很少有记录。《国际疾病和相关健康问题分类第十次修订临床修改》（ICD-10-CM）首次在医学编码中区分了确诊和疑似儿童虐待。这种区别在实践中的效用尚不清楚。本研究旨在根据患者的人口统计学特征和损伤类型来评估这些代码的应用。方法对确认（T74）或疑似（T76）虐待儿童的18岁以下ICD-10-CM代码患儿急诊出院记录进行二次资料分析。儿童年龄、性别、种族/民族、保险状况和共发生伤害（500 - t88）按虐待类型（确诊或疑似）进行比较。结果从2016年到2018年，1650次独特的ED就诊记录了儿童虐待，即每10000次ED就诊中有21.7次。最常记录的是疑似虐待（58%）。所有与虐待有关的访问中有一半涉及性虐待，最常见的是女性和非西班牙裔白人。36%的探视记录了身体虐待；主要是头部受伤。非西班牙裔黑人儿童被证实的身体虐待比被怀疑的更频繁(38.7% vs 23.7%, p
BackgroundChild maltreatment is poorly documented in clinical data. The International Classification of Diseases and Related Health Problems, 10th Revision, Clinical Modification (ICD-10-CM) represents the first time that confirmed and suspected child maltreatment can be distinguished in medical coding. The utility of this distinction in practice remains unknown. This study aims to evaluate the application of these codes by patient demographic characteristics and injury type.MethodsWe conducted secondary data analysis of emergency department (ED) discharge records of children under 18 years with an ICD-10-CM code for confirmed (T74) or suspected (T76) child maltreatment. Child age, sex, race/ethnicity, insurance status and co-occurring injuries (S00-T88) were compared by maltreatment type (confirmed or suspected).ResultsFrom 2016 to 2018, child maltreatment was documented in 1650 unique ED visits, or 21.7 per 10 000 child ED visits. Suspected maltreatment was documented most frequently (58%). Half of all maltreatment-related visits involved sexual abuse, most often in females and individuals of non-Hispanic white race. Physical abuse was coded in 36% of visits; injuries to the head were predominant. Non-Hispanic black children were more frequently documented with confirmed physical abuse than suspected (38.7% vs 23.7%, p