Objectives To determine whether children who have child maltreatment allegation or substantiation have a higher rate of general hospital admissions and injury related admissions when compared to other children and to investigate other types of admissions, such as mental health, infections and admissions due to external causes.
Study design A prospective matched case-control study of children born in Western Australia between 1990 and 2005 using de-identified record linked Child Protection and Hospital Morbidity data. Rates of prior hospital admissions for cases versus controls were calculated, and conditional logistic regression was used to estimate the effect of hospital admission rate on the risk of child maltreatment allegation and substantiated allegation.
Results Children with child maltreatment allegations and substantiations had higher mean prior admission rates compared to controls. Higher rates of general admissions and admissions for injuries, infections, mental and behavioural disorders, and external causes of morbidity, were associated with a markedly increased risk of child maltreatment allegations and substantiation.
Conclusions The hospital system plays not only an important role both in the surveillance of maltreatment-related injuries and conditions but also in the role of prevention in the referral of families who may need support and assistance in ensuring the health and safety of their children. This research highlights the importance of moving to electronic patient records in identifying children who have high rates of admissions and the types of conditions they have previously presented with, particularly for injuries, mental and behavioural disorders and external causes of admissions.
- Hospital morbidity
- child abuse
- child health
- violence RB
- Accepted 14 August 2009
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Funding Australian Research CouncilWestern Australian Government. Melissa O'Donnell was supported by an Australian Postgraduate Award Industry Scholarship, provided through an Australian Research Council Linkage Project Grant (LP0455417). The Western Australian Government Departments of Health, Child Protection, Education, Disability Services, Corrective Services and Attorney General who provided support as well as data for this project. Dr Nassar is supported by a Public Health Fellowship (404198) from the National Health and Medical Research Council of Australia.
Competing interests None.
Ethics approval This study was conducted with the approval of the University of Western Australia Human Ethics Committee Confidentiality of Health Information Committee Western Australian Aboriginal Human Information and Ethics Committee.
Provenance and peer review Not commissioned; externally peer reviewed.
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