Details

Autor(en) / Beteiligte

• Diyaolu, Modupeola
• Ye, Chaonan
• Huang, Zhuoyi
• Han, Ryan
• Wild, Hannah
• Tennakoon, Lakshika
• Spain, David A.
• Chao, Stephanie D.

Titel

Disparities in detection of suspected child abuse

Ist Teil von

• Journal of pediatric surgery, 2023-02, Vol.58 (2), p.337-343

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2023

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• •Child abuse patients are more severely injured and have a higher mortality than other pediatric patients.•White children of abuse are more severely injured and have a higher hospital mortality than black children of abuse.•Black children are disproportionally overidentified as children of abuse and are hospitalized longer than white children despite being less severely injured. Child abuse is a significant cause of injury and death among children, but accurate identification is often challenging. This study aims to assess whether racial disparities exist in the identification of child abuse. The 2010–2014 and 2016–2017 National Trauma Data Bank was queried for trauma patients ages 1–17. Using ICD-9CM and ICD-10CM codes, children with injuries consistent with child abuse were identified and analyzed by race. Between 2010–2014 and 2016–2017, 798,353 patients were included in NTDB. Suspected child abuse victims (SCA) accounted for 7903 (1%) patients. Of these, 51% were White, 33% Black, 1% Asian, 0.3% Native Hawaiian/Other Pacific Islander, 2% American Indian, and 12% other race. Black patients were disproportionately overrepresented, composing 12% of the US population, but 33% of SCA patients (p < 0.001). Although White SCA patients were more severely injured (ISS 16–24: 20% vs 16%, p < 0.01) and had higher in-hospital mortality (9% vs. 6%, p = 0.01), Black SCA patients were hospitalized longer (7.2 ± 31.4 vs. 6.2 ± 9.9 days, p < 0.01) despite controlling for ISS (1–15: 4. 5.7 ± 35.7 vs. 4.2 ± 6.2 days, p < 0.01). In multivariate regression, Black children continued to have longer lengths of stay despite controlling for ISS and insurance type. Utilizing a nationally representative dataset, Black children were disproportionately identified as potential victims of abuse. They were also subjected to longer hospitalizations, despite milder injuries. Further studies are needed to better understand the etiology of the observed trends and whether they reflect potential underlying unconscious or conscious biases of mandated reporters. Treatment study. III.