Health services utilization and cost of abusive head trauma in Taiwan: A population-based retrospective matched cohort study

Yi Ting Chang, Jui Ying Feng, Hsin Yi Chang, Tsung Hsueh Lu, Joulan Wu, Yu Chun Chang

研究成果: Article同行評審

摘要

Background: Abusive head trauma (AHT) is a serious health problem that results the highest mortality among children who are maltreated. Many AHT survivors suffer from long-term sequelae and require medical treatment. However, the knowledge of AHT-attributable health services utilization and costs at national level are limited. Objective: To estimate health services utilization and costs attributable to AHT among children aged 0–4 years in Taiwan. Participants and setting: Sixty-three fatal and 664 survival AHT cases were identified using Taiwan national population database between 2003 and 2015. A total of 2656 non-AHT children were exactly 4:1 matched to the survival cases based on their birth year, gender, the calendar year of the index date, insured location, and health insurance premium (social economic status indicator). Methods: Health services utilization and costs were calculated on an annual basis for 3 years after the index date. AHT-attributable health services utilization and costs during 3-year follow-up period was evaluated by regression models. Results: AHT diagnosis was positively associated with inpatient admissions, length of stay, emergency room (ER) visits, and outpatient visits. AHT-attributable medical costs were 1.64–17.27 times, 1.25–5.22 times, and 1.77–2.36 times greater for inpatient, ER, and outpatient during 3-year period than matched controls, respectively. Fatal AHT cases had higher inpatient utilization and greater medical costs than AHT survivors. Conclusions: Children with AHT had greater health services utilization and higher costs for years. Strategies to reduce the burden of AHT on health care system are imperative.

原文English
文章編號105603
期刊Child Abuse and Neglect
128
DOIs
出版狀態Published - 2022 6月

All Science Journal Classification (ASJC) codes

  • 兒科、圍產兒和兒童健康
  • 發展與教育心理學
  • 精神病學和心理健康

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