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Clin Pediatr (Phila). 2019 May 1:9922819845895. doi: 10.1177/0009922819845895. [Epub ahead of print]

Identification of Child Maltreatment-Related Emergency Department Visits in Connecticut, 2011 to 2014.

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1 Injury Prevention Center, Connecticut Children's Medical Center, Hartford, CT, USA.
2 Department of Pediatrics, School of Medicine, University of Connecticut, Farmington, CT, USA.
3 Department of Community Medicine and Health Care, School of Medicine, University of Connecticut, Farmington, CT, USA.
4 Department of Pediatics, Drexel University College of Medicine, Philadelphia, PA, USA.


Child maltreatment identified by medical professionals is poorly represented in records of child protection. International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes may better represent the burden of maltreatment treated in clinical settings. Using emergency department (ED) discharge data from 2011 to 2014, we enumerated presentations of maltreatment treated in Connecticut EDs for children under 10 years. Of 790 080 discharges, child maltreatment was explicitly documented in 265 (0.03%) unique ED visits, consistent with prior studies. Sexual maltreatment was most prevalent. A total of 3634 visits included an ICD-9-CM code suggestive of maltreatment. Children with these codes were significantly younger, more likely to be of white race, and use private insurance. Use of ICD codes in child maltreatment surveillance may elucidate characteristics of maltreatment not captured by child welfare data. Combining ICD codes for explicit and suggestive maltreatment will aid in understanding the extent of this problem.


ICD-9-CM; child maltreatment; emergency department discharges; public health surveillance


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