TY  - JOUR
PY  - 2022//
TI  - Diagnosis codes dramatically underestimate the burden of abuse
JO  - Child abuse and neglect
A1  - Brink, Farah W.
A1  - Lo, Charmaine B.
A1  - Shi, Junxin
A1  - Stanley, Rachel
A1  - Lindberg, Daniel M.
SP  - e105986
EP  - e105986
VL  - 135
IS  - 
N2  - BACKGROUND: International Classification of Diseases (ICD) billing codes are not well-suited to estimate physical abuse prevalence among hospitalized patients and may be even less accurate in emergency departments (EDs). The Centers for Disease Control and Prevention (CDC) has recently published a child abuse and neglect syndromic surveillance definition to more accurately examine national abuse trends among ED visits. <br><br>OBJECTIVE: To retrospectively apply the CDC syndromic definition to a population of physically abused children and determine its sensitivity for abuse in an ED and at hospital discharge.     PARTICIPANTS AND SETTING: All physically abused children <5 years seen in the ED and evaluated by the child protection team from 2016 to 2020 at a large Midwestern children's hospital. <br><br>METHODS: Retrospective cross-sectional study utilizing the hospital's child protection team administrative database, the Pediatric Health Information System and the electronic health record to identify the study sample, chief complaint, and abuse-specific codes assigned in the ED and at hospital discharge. Abuse-specific codes were defined as all ICD-10-CM and Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT) codes included in the CDC syndromic definition, which was applied to the sample and its sensitivity determined. <br><br>RESULTS: Among the 550 abused patients identified, most were male (58.4 %), white (65.1 %), <2 years old (80.4 %), and had public insurance (81.6 %). When applying the CDC syndromic definition, only 11.6 % were identified as abused in the ED and 65.3 % were identified at hospital discharge. <br><br>CONCLUSIONS: The CDC syndrome surveillance definition lacks sensitivity in identifying abuse in the ED or at hospital discharge.<p />  <p>Language: en</p>
LA  - en
SN  - 0145-2134
UR  - http://dx.doi.org/10.1016/j.chiabu.2022.105986
ID  - ref1
ER  -