Evidence map›Paper›PMID 35275403›Full record

ArticleHealth services research2022

An algorithm using administrative data to measure adverse childhood experiences (ADM-ACE).

Laura E Henkhaus, Gilbert Gonzales, Melinda B Buntin

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Article in Health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

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2citing papers in PubMed
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3 · Its place in the literature

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2 citing papers in PubMed.

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5 · Who and what money

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3 authors.

Laura E HenkhausData Science Institute, Vanderbilt University, Nashville, Tennessee, USA.ORCID 0000-0001-6663-4549
Gilbert GonzalesDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.ORCID 0000-0002-4054-6564
Melinda B BuntinDepartment of Health Policy, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo develop an algorithm using administrative data to measure adverse childhood experiences (ADM-ACE) within routinely collected health insurance claims and enrollment data. DATA SOURCES: We used claims and enrollment data from Tennessee's Medicaid program (TennCare) in 2018. STUDY

designWe studied five types of ACEs: maltreatment and peer violence, foster care and family disruption, maternal mental illness, maternal substance use disorder, and abuse of the mother. We used diagnosis and procedure codes, prescription drug fills, and enrollment files to develop the ADM-ACE, which we applied to measure the prevalence of ACEs and to examine prevalence by demographic characteristics among our sample of children in TennCare. We compared ADM-ACE prevalence to child welfare records and survey results from Tennessee. DATA COLLECTION/EXTRACTION

methodsOur study sample included children aged 0-17 years who were linked to their mothers if also enrolled in TennCare in 2018 (N = 763,836 children). PRINCIPAL

findingsApproximately 19.2% of children in TennCare had indicators for ADM-ACEs. The prevalence of ACEs was higher among children who were younger (p < 0.001), non-Hispanic white or black (compared to Hispanic) (p < 0.001), and children residing in rural versus urban counties (p < 0.001). The prevalence of maltreatment identified through the ADM-ACE (1.6%) falls between the percent of children in Tennessee who were reported to child welfare authorities and the percent for whom reports of maltreatment were substantiated. Comparison with survey reports from Tennessee parents suggests an advantage in measuring maternal mental illness with the ADM-ACE using health insurance claims data.

conclusionsThe ADM-ACE can be applied to health encounter data to study and monitor the prevalence of certain ACEs, their association with health conditions, and the effects of policies on reducing exposure to ACEs or improving health outcomes for children with ACEs.

Indexed as

Adverse Childhood ExperiencesChild AbuseAlgorithmsChildFemaleHispanic or LatinoHumansRural PopulationUnited Statesadministrative data usesadverse childhood experienceschild and adolescent healthchild welfaredeterminants of healthMedicaidobservational datapediatrics

Identifiers

PMID35275403
PMCPMC9264467

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