Evidence map›Paper›PMID 36330904›Full record

ArticleChild abuse & neglect2022

Do children evaluated for maltreatment have higher subsequent emergency department and inpatient care utilization compared to a general pediatric sample?

Yuerong Liu, Megan Shepherd-Banigan, Kelly E Evans, Laura Stilwell, Lindsay Terrell, Jillian H Hurst, Elizabeth J Gifford

Abstract read
In one paragraph

Article in Child abuse & neglect, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Response to Stillwell and Merritt.The Journal of pediatrics · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Yuerong LiuCenter for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America. Electronic address: yuerong.liu@duke.edu.
Megan Shepherd-BaniganMargolis Center for Health Policy, Duke University, Durham, NC, United States of America; Department of Population Health Sciences, School of Medicine, Duke University, Durham, NC, United States of America; Durham VA Healthcare System, Durham, NC, United States of America.
Kelly E EvansCenter for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America.
Laura StilwellSanford School of Public Policy, Duke University, Durham, NC, United States of America; School of Medicine, Duke University, Durham, NC, United States of America.
Lindsay TerrellDepartment of Pediatrics, School of Medicine, Duke University, Durham, NC, United States of America; Department of Pediatrics, Duke Children's Primary Care, Duke University Medical Center, Durham, NC, United States of America.
Jillian H HurstDepartment of Pediatrics, Division of Infectious Diseases, Duke University, Durham, NC, United States of America; Children's Health and Discovery Initiative, Duke University, Durham, NC, United States of America.
Elizabeth J GiffordCenter for Child and Family Policy, Duke University, Durham, NC, United States of America; Sanford School of Public Policy, Duke University, Durham, NC, United States of America; Margolis Center for Health Policy, Duke University, Durham, NC, United States of America; Department of Pediatrics, School of Medicine, Duke University, Durham, NC, United States of America; Children's Health and Discovery Initiative, Duke University, Durham, NC, United States of America.

Funding

MEDICAL SCIENTIST TRAINING PROGRAMT32GM007171 · NIGMS · DUKE UNIVERSITY · PI KONTOS, CHRISTOPHER D · 1985 to 2021
$31.2M
Medical Scientist Training Program Training GrantT32GM145449 · NIGMS · DUKE UNIVERSITY · PI Christopher D Kontos · 2022 to 2026
$6.6M
NIGMS NIH HHS T32 GM007171NIGMS NIH HHS T32 GM145449
6 · The paper itself

Abstract

backgroundChild maltreatment leads to substantial adverse health outcomes, but little is known about acute health care utilization patterns after children are evaluated for a concern of maltreatment at a child abuse and neglect medical evaluation clinic.

objectiveTo quantify the association of having a child maltreatment evaluation with subsequent acute health care utilization among children from birth to age three. PARTICIPANTS AND

settingChildren who received a maltreatment evaluation (N = 367) at a child abuse and neglect subspecialty clinic in an academic health system in the United States and the general pediatric population (N = 21,231).

methodsWe conducted a retrospective cohort study that compared acute health care utilization over 18 months between the two samples using data from electronic health records. Outcomes were time to first emergency department (ED) visit or inpatient hospitalization, maltreatment-related ED use or inpatient hospitalization, and ED use or inpatient hospitalization for ambulatory care sensitive conditions (ACSCs). Multilevel survival analyses were performed.

resultsChildren who received a maltreatment evaluation had an increased hazard for a subsequent ED visit or inpatient hospitalization (hazard ratio [HR]: 1.3, 95 % confidence interval [CI]: 1.1, 1.5) and a maltreatment-related visit (HR: 4.4, 95 % CI: 2.3, 8.2) relative to the general pediatric population. A maltreatment evaluation was not associated with a higher hazard of health care use for ACSCs (HR: 1.0, 95 % CI: 0.7, 1.3).

conclusionThis work can inform targeted anticipatory guidance to aid high-risk families in preventing future harm or minimizing complications from previous maltreatment.

Indexed as

Child AbuseInpatientsChildEmergency Service, HospitalHospitalizationHumansRetrospective StudiesUnited StatesChild maltreatmentChild protectionHealth care utilizationHealth servicesPediatrics

Identifiers

PMID36330904
PMCPMC11025450

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.