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Quality of child abuse information in emergency department injury surveillance data : linking hospital and child welfare data

Scott, Debbie, McKenzie, Kirsten, Fraser, Jennifer A., & Dunne, Michael P. (2010) Quality of child abuse information in emergency department injury surveillance data : linking hospital and child welfare data. In ISPCAN XVIII Congress, 26-29 September 2010, Hawai‘i Convention Center, Honolulu. (Unpublished)

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Abstract

Emergency departments (EDs) are often the first point of contact with an abused child. Despite legal mandate, the reporting of definite or suspected abusive injury to child safety authorities by ED clinicians varies due to a number of factors including training, access to child safety professionals, departmental culture and a fear of ‘getting it wrong’. This study examined the quality of documentation and coding of child abuse captured by ED based injury surveillance data and ED medical records in the state of Queensland and the concordance of these data with child welfare records. A retrospective medical record review was used to examine the clinical documentation of almost 1000 injured children included in the Queensland Injury Surveillance Unit database (QISU) from 10 hospitals in urban and rural centres. Independent experts re-coded the records based on their review of the notes. A data linkage methodology was then used to link these records with records in the state government’s child welfare database. Cases were sampled from three sub-groups according to the surveillance intent codes: Maltreatment by parent, Undetermined and Unintentional injury. Only 0.1% of cases coded as unintentional injury were recoded to maltreatment by parent, while 1.2% of cases coded as maltreatment by parent were reclassified as unintentional and 5% of cases where the intent was undetermined by the triage nurse were recoded as maltreatment by parent. Quality of documentation varied across type of hospital (tertiary referral centre, children’s, urban, regional and remote). Concordance of health data with child welfare data varied across patient subgroups. Outcomes from this research will guide initiatives to improve the quality of intentional child injury surveillance systems.

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ID Code: 38232
Item Type: Conference Item (Presentation)
Keywords: child maltreatment, emergency department, surveillance
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Public Health and Health Services not elsewhere classified (111799)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Research Centres > National Centre for Health Information Research & Training
Current > Schools > School of Public Health & Social Work
Copyright Owner: Copyright 2010 The Authors
Deposited On: 29 Oct 2010 07:23
Last Modified: 10 Apr 2013 10:05

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