The impact of COVID-19 on child maltreatment-related medical encounters and system responses using linked administrative data

使用链接的管理数据了解 COVID-19 对儿童虐待相关医疗事件和系统响应的影响

• 批准号: 10794523
• 负责人: Rebecca Rebbe
• 金额: $ 25.21万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-03-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10794523
• 关键词: impact; COVID; 19; child; maltreatment

Project Summary/Abstract: With schools and daycare facilities closed and unemployment rates soaring due to the COVID- 19 pandemic, experts worry not only that the incidence of child maltreatment has increased but that that new or recurrent cases of maltreatment have gone undetected because two-thirds of reports to child protective services (CPS) are made by professionals. Linked administrative data (i.e., records collected for the provision of services, including health and child protection) can overcome the challenges of relying solely on CPS reports by joining the CPS database with medical records. Medical records have been identified as a useful data source for measuring child maltreatment. The objective of this application is to determine if and how the COVID-19 pandemic has impacted the incidence of child maltreatment-related medical encounters and the system responses to diagnosed cases of maltreatment. The rationale is maltreatment has significant identified impacts on children and if maltreatment has increased during this time, it will be important to allocate resources to address this detrimental form of trauma. The proposed study will take advantage of a natural experiment to focus on two specific aims: 1) Compare the incidence rates of child maltreatment-related medical encounters, before and during COVID-19; and 2) Determine the social and legal interventions/system responses to diagnosed medical encounters of child maltreatment before and during the pandemic. For the first aim, an interrupted time series will be used to identify the frequency of diagnosed maltreatment in primary care, emergency department, and hospitalization medical encounters. For the second aim, interrupted time series and logistic regression will be used to determine the percentage and likelihood of diagnosed maltreatment-related medical encounters being reported to CPS. The proposed research is innovative because it uses data from multiple sources and includes several types of medical encounters. The proposed research is significant because maltreatment is highly consequential but difficult to measure. Results will identify with robust empirical evidence if the pandemic COVID-19 has increased the incidence and severity of child maltreatment-related medical encounters and changed the social and legal interventions in response to such medical encounters. Ultimately, such knowledge has the potential to identify how community-level events impact child maltreatment, informing public policy, resource allocation, professional training, and future research.

项目摘要/摘要： 随着学校和日托设施的关闭和失业率飙升，原因是 19大流行，专家不仅担心儿童虐待的发生率有所增加，而且还在 由于三分之二 向儿童保护服务（CPS）的报告是由专业人士进行的。链接的管理数据 （即，收集的用于提供服务的记录，包括健康和儿童保护）可以 通过加入CPS数据库，克服仅依靠CPS报告的挑战 病历。病历已被确定为测量的有用数据源 儿童虐待。该应用的目的是确定如何以及如何以及如何 大流行影响了与儿童虐待有关的医疗遭遇的发生率， 系统对被诊断的虐待病例的反应。理由是虐待 对儿童产生的重大影响以及在此期间虐待增加的话， 分配资源以解决这种有害形式的创伤非常重要。提议 研究将利用自然实验，重点关注两个特定目的：1）比较 与儿童虐待相关的医疗遭遇的发病率，在Covid-19之前和期间； 2）确定对诊断医学的社会和法律干预措施/系统响应 大流行前后儿童虐待的遭遇。为了第一个目标 中断时间序列将用于确定诊断为虐待的频率 初级保健，急诊科和住院医疗遭遇。第二个 目标，中断时间序列和逻辑回归将用于确定百分比和 向CPS报告了被诊断出与虐待有关的医疗遭遇的可能性。这 拟议的研究具有创新性，因为它使用了来自多个来源的数据，包括 几种类型的医疗遭遇。拟议的研究很重要，因为 虐待是高度结果，但难以衡量。结果将以强大的识别 经验证据，如果大流行期19增加了儿童的发病率和严重程度 与虐待有关的医疗遭遇，改变了社会和法律干预措施 对这种医疗遭遇的反应。最终，这种知识有潜力确定 社区级事件如何影响儿童虐待，告知公共政策，资源 分配，专业培训和未来研究。

项目成果

The Impact of COVID-19 on Infant Maltreatment Emergency Department and Inpatient Medical Encounters.

• DOI: 10.1016/j.jpeds.2023.113582
• 发表时间: 2023-11
• 期刊: JOURNAL OF PEDIATRICS
• 影响因子: 5.1
• 作者: Rebbe, Rebecca;Reddy, Julia;Kuelbs, Cynthia L.;Huang, Jeannie S.;Putnam-Hornstein, Emily
• 通讯作者: Putnam-Hornstein, Emily