Saturday, 15 January 2005 - 4:00 PM

This presentation is part of: Health Services

Medical Costs Associated with Childhood Inflicted Injuries Seen in New York City Hospital Settings

Violence against children has been widely studied; yet, there is a gap in research conducted in hospital settings. This study aimed to highlight the need for promoting and improving hospital-based research and for creating possible prevention and intervention strategies in hospitals. This paper described children/youths who were hospitalized due to inflicted injuries in New York City (NYC). Hospital factors such as types of injuries, length of stay, total charge, disposition and admission types were examined to clarify the medical costs associated with violence-related injuries among children/youths and to bring awareness to professionals who deal with child/youth violence.

The Statewide Planning and Research Cooperative System (SPARCS) Inpatient Output Data 2000 was used to select children who were under the age of 18 years and who were admitted for inflicted injuries (intentionally inflicted, not self-inflicted, non-suicidal) in five boroughs of New York City (Bronx, Brooklyn, Manhattan, Staten Island, and Queens; N=1,100). “Assault” cases were extracted based on the external cause-of-injury codes (E960 – E968). Hospital factors and demographic variables such as gender, age and race of child were entered into regression analyses to identify predictors of the medical costs associated with violence-related injuries.

Descriptive analyses showed that male children (82%), African American (non-Hispanic) children (46%), older children (Mean age = 14.5), children from Brooklyn and Bronx (38% and 24%, respectively) were more likely to be hospitalized due to assault-related injuries. About 50% of reimbursement was made through Medicaid/HMO and over 64% of it involved African-American and Hispanic children/youths. Moreover, it was found that about 26% of expected reimbursement was categorized as “self-pay.” The results showed that younger children stayed longer in hospitals, were more likely to be injured at home, and were assaulted by “child battering” while older children were more likely to be injured on the street and by “firearms” and “cutting.” The mean total charge was $14,022, and higher charge was associated with “child battering,” followed by “firearms.” Female children were more likely to suffer from child abuse related injuries. Regression analyses showed that admission type, injury type, race, and age predicted the length of stay in hospital. The total charges were more likely to be higher for children/youths who were admitted as urgent, hospitalized due to firearm-related, and child abuse related injuries.

As the study results indicated that more children were hospitalized due to “cutting,” and daily medical costs for such injuries were higher than expected, more research should focus on this area. It is also necessary to gather thorough information on patients and perpetrators in cases of violence-related injuries. Better knowledge and information on perpetrators are needed in order to respond adequately to violence-related injured patients and their families. Most of children in the study (90.3%) were discharged and sent home where violence might still exist or where there might be a high probability of re-exposure to violence. This urges the necessity of longitudinal research to track re-admission of children who were already exposed to violence.

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