Serious physical abuse rates highest in infants, Medicaid patients

Children younger than 1 year and children on Medicaid are the most likely to suffer serious injuries because of physical abuse, according to an analysis of data from a US database. The study was the first to provide estimates on the number of US children hospitalized as a result of serious injuries from physical abuse.

Using data from the 2006 Kids’ Inpatient Database (KID), a weighted US sample of discharged patients from nonrehabilitation hospitals, researchers estimated the incidence of hospitalizations resulting from serious physical abuse among US children younger than 18 years. Abuse was defined using International Classification of Diseases, Ninth Revision, Clinical Modification codes for physical abuse, assault, or child battering. Demographic characteristics, mean costs, and length of stay were compared in children hospitalized for abusive injuries, nonabusive injuries, and other reasons.

In 2006, 4,569 children (6.2 per 100,000 children <18 years) were hospitalized with serious injuries because of physical abuse; 300 died. The incidence of hospitalization because of abuse was highest during the first year of life (58.2 per 100,000 infants). The most striking finding was that in each age group, the incidence was about 6 times higher in children covered by Medicaid than in children with other types of medical insurance.

Hospital stays were longer and hospital costs higher for children with abusive injuries than for the other groups. The national costs of hospitalization for abused children calculated from the 2006 KID were nearly $74 million. The total lifetime economic burden from new cases of fatal and nonfatal child maltreatment in the United States is estimated at approximately $124 billion.

The findings of the study could be useful in tracking trends over time and in evaluating the effects of large-scale abuse prevention programs, the researchers conclude.

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