Health care utilization pattern prior to maltreatment among children under five years of age in Taiwan |
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| Institution: | 1. Social & Community Reintegration Research Program, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA;2. Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA;3. VISN 1 New England MIRECC, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA, USA;4. University of Massachusetts Medical School, Addiction Division, Worcester, MA, USA;5. Yale University, New Haven, CT, USA;6. University of Connecticut, Storrs, CT, USA;7. University of Nevada, Las Vegas, Department of Psychology, Las Vegas, NV, USA;1. School of Psychology, Trinity College Dublin, Ireland;2. Health Service Executive, Cork, Ireland;1. Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan;2. Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan;3. International Doctoral Program in Nursing, Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan;1. The Ohio State University College of Medicine, 370 West 9th Avenue, Columbus, OH 43210, USA;2. Center for Pediatric Trauma Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA;3. Center for Injury Research and Policy, Abigail Wexner Research Institute at Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA;4. The Center for Family Safety and Healing, Nationwide Children''s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA;5. Trauma Program, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA;1. Faculty of Social Sciences, University of Helsinki, P.O. Box 18, FI-00014, Helsinki, Finland;2. National Institute for Health and Welfare, THL, P.O. Box 310, FI-90101, Oulu, Finland;3. Finnish Youth Research Network, Asemapäällikönkatu 1, FI-00520, Helsinki, Finland;4. Institute of Clinical Medicine, University of Eastern Finland, P.O. Box 1627 (Mediteknia building), FI-70211, Kuopio, Finland;1. Psychiatry Registrar, C/- Metro South Addiction and Mental Health Service, Building 19, Princess Alexandra Hospital, Woolloongabba, Queensland, 4102, Australia;2. School of Medicine, University of Queensland, Princess Alexandra Hospital, Woolloongabba, 4102, Queensland, Australia;3. School of Public Health, University of Queensland, Herston, Queensland 4006, Australia;4. School of Medicine, University of Queensland, c/-Deparment of Paediatrics, Logan Hospital, Logan, Queensland, 4129, Australia |
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| Abstract: | BackgroundSeveral studies have hypothesized that the pattern of health care utilization among maltreated children differ from others without the experience. However, the conclusions have not been consistent.ObjectiveThe study aims to examine whether the pattern of health care utilization among children 0–5 years old with maltreatment different from their counterparts without maltreatment in Taiwan.Subjects and SettingAll children born in 2007 in Taiwan.MethodThis is a population-based and case-controlled study. Cases are children under five years of ago with maltreatment-related diagnosis in the claims data of the National Health Insurance in Taiwan during the 2007–2013 period. For each case, there were 10 birth date-matched controls. Exposure variables include the number of injury or non-injury-related outpatients, emergency department (ED) visits, and hospitalization. Multivariate models were employed, with adjustment for sex, urbanization level, and comorbidities of children.ResultsOf children born in 2007, 382 had maltreatment-related diagnosis during the age of 0–5. The adjusted odds ratio (aOR) for having two or more ED visits with or without injury-related diagnosis is 3.52 (95% CI 1.75–7.07) and 2.0-0 (95% CI 1.47–2.72), respectively. Children with maltreatment also had significantly higher number of hospitalization without injury-related diagnosis and aOR for those having two more hospitalizations stands at 2.47 (95% CI 1.59–3.83).ConclusionsChildren with maltreatment when 0–5 years old had higher number of ED visits with injury-related diagnosis, as well as hospitalization without injury-related diagnosis. Recognition of the health care utilization is conducive to early identification of children with risk for maltreatment. |
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| Keywords: | Child abuse Child maltreatment Health care utilization Emergency department Hospitalization |
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