The impact of COVID-19 on child maltreatment-related medical encounters and system responses using linked administrative data

使用链接的管理数据了解 COVID-19 对儿童虐待相关医疗事件和系统响应的影响

• 批准号: 10286451
• 负责人: Rebecca Rebbe
• 金额: $ 22.62万
• 依托单位: UNIVERSITY OF SOUTHERN CALIFORNIA
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-20 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10286451
• 关键词: Accident and Emergency department; Address; Age; Area; COVID-19; COVID-19 pandemic; Case Study; Child; Child Abuse and Neglect; Child Health; Childhood Injury; Communities; Consequentialism; Continuity of Patient Care; Critical Illness; Data; Data Set; Data Sources; Databases; Diagnosis; Disease Outbreaks; Emergency Situation; Emergency department visit; Epidemic; Event; Frequencies; Fright; Health protection; Healthcare Systems; Hospitalization; Incidence; Interruption; Knowledge; Legal Intervention; Link; Logistic Regressions; Measures; Medical; Medical Records; Modeling; National Institute of Child Health and Human Development; Natural experiment; Population; Primary Health Care; Provider; Public Health; Public Policy; Records; Recurrence; Reporting; Research; Resource Allocation; Resources; Safety; Schools; Series; Service provision; Severities; Shelter facility; Social Change; Source; Strategic Planning; System; Time; Training; Trauma; Unemployment; adolescent health; child protection; child protective service; family support; improved; innovation; maltreatment; multiple data sources; newspaper article; pandemic disease; pediatric trauma; population based; response; social interventions

Project Summary/Abstract: With schools and daycare facilities closed and unemployment rates soaring due to the COVID- 19 pandemic, experts worry not only that the incidence of child maltreatment has increased but that that new or recurrent cases of maltreatment have gone undetected because two-thirds of reports to child protective services (CPS) are made by professionals. Linked administrative data (i.e., records collected for the provision of services, including health and child protection) can overcome the challenges of relying solely on CPS reports by joining the CPS database with medical records. Medical records have been identified as a useful data source for measuring child maltreatment. The objective of this application is to determine if and how the COVID-19 pandemic has impacted the incidence of child maltreatment-related medical encounters and the system responses to diagnosed cases of maltreatment. The rationale is maltreatment has significant identified impacts on children and if maltreatment has increased during this time, it will be important to allocate resources to address this detrimental form of trauma. The proposed study will take advantage of a natural experiment to focus on two specific aims: 1) Compare the incidence rates of child maltreatment-related medical encounters, before and during COVID-19; and 2) Determine the social and legal interventions/system responses to diagnosed medical encounters of child maltreatment before and during the pandemic. For the first aim, an interrupted time series will be used to identify the frequency of diagnosed maltreatment in primary care, emergency department, and hospitalization medical encounters. For the second aim, interrupted time series and logistic regression will be used to determine the percentage and likelihood of diagnosed maltreatment-related medical encounters being reported to CPS. The proposed research is innovative because it uses data from multiple sources and includes several types of medical encounters. The proposed research is significant because maltreatment is highly consequential but difficult to measure. Results will identify with robust empirical evidence if the pandemic COVID-19 has increased the incidence and severity of child maltreatment-related medical encounters and changed the social and legal interventions in response to such medical encounters. Ultimately, such knowledge has the potential to identify how community-level events impact child maltreatment, informing public policy, resource allocation, professional training, and future research.

项目摘要/摘要： 由于新冠疫情，学校和日托设施关闭，失业率飙升， 19大流行，专家担心不仅虐待儿童发生率上升， 新的或反复发生的虐待案件没有被发现，因为三分之二的虐待案件 向儿童保护服务机构 (CPS) 的报告由专业人员进行。关联的管理数据 （即为提供服务而收集的记录，包括健康和儿童保护）可以 通过加入 CPS 数据库，克服仅依赖 CPS 报告的挑战 医疗记录。医疗记录已被确定为测量的有用数据源 虐待儿童。此应用程序的目的是确定 COVID-19 是否以及如何 大流行影响了与虐待儿童相关的医疗事件的发生率， 系统对已诊断的虐待案件的反应。理由是虐待 已确定对儿童产生重大影响，如果在此期间虐待行为有所增加， 分配资源来解决这种有害形式的创伤非常重要。拟议的 研究将利用自然实验来关注两个具体目标：1）比较 COVID-19 之前和期间与虐待儿童相关的医疗事件的发生率； 2) 确定对确诊医疗的社会和法律干预措施/系统反应 在大流行之前和期间遭遇虐待儿童的情况。为了实现第一个目标， 中断时间序列将用于确定诊断虐待的频率 初级保健、急诊科和住院医疗遭遇。对于第二个 目标、中断时间序列和逻辑回归将用于确定百分比和 向 CPS 报告诊断出的与虐待相关的医疗事件的可能性。这 拟议的研究具有创新性，因为它使用来自多个来源的数据，并包括 几种类型的医疗遭遇。拟议的研究意义重大，因为 虐待造成的后果非常严重，但难以衡量。结果将与稳健的 经验证据表明，新冠肺炎 (COVID-19) 大流行是否增加了儿童的发病率和严重程度 虐待相关的医疗遭遇并改变了社会和法律干预措施 对此类医疗遭遇的反应。最终，这些知识有可能识别 社区级事件如何影响虐待儿童、为公共政策、资源提供信息 分配、专业培训和未来的研究。