Evaluation of the effect of the child protection act on serious child physical abuse in Taiwan |
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| Institution: | 1. Department of Pediatric Intensive Care, Nagano Children''s Hospital, 3100, Toyoshina, Azumino City, Nagano, 399-8288, Japan;2. Division of Emergency Service and Transport Medicine, National Center for Child Health and Development, 2-10-1, Okura, Setagaya-ku, Tokyo, 157-8535, Japan;3. Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, 30-1, Otaniguti, Kami-chou, Itabashi-ku, Tokyo, 173-8610, Japan;1. Department of Nursing, College of Medicine, National Cheng Kung University, 1 University Rd., Tainan 70101, Taiwan;2. Department of Nursing, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng Li Rd., Tainan 70403, Taiwan;3. Department of Public Health, College of Medicine, National Cheng Kung University, 138 Sheng Li Rd., Tainan 70403, Taiwan;4. Health Intelligence Company, 225 N Michigan Ave, Chicago, IL 60601-7757, United States;5. School of Nursing, College of Medicine, National Taiwan University, 1, Sec. 1, Jen-Ai Rd., Taipei 10051, Taiwan |
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| Abstract: | BackgroundFew studies have examined the effects of the Child Protection Act on child maltreatment in Taiwan.ObjectiveThis study estimated the secular trends in the incidence rate of physical abuse of children requiring hospitalization between 1996 and 2013, and the subsequent in-hospital death proportion before and after implementation of the Act in 2003.Participants and settingThe cases were children younger than 12 years old who were hospitalized due to child abuse, shaken-baby syndrome, neglect, or homicide between 1996 and 2013. A comparison group consisted of children requiring hospitalization for other reasons. We used the National Health Insurance database to identify patients.MethodsThe Joinpoint Regression Program was used to estimate temporal trends in the standardized incidence rates.ResultsBetween 1996 and 2013, 2050 children required hospitalization for physical abuse. Before 2005, the annual percent change increased by 9.40 95% confidence interval (CI), 4.98–14.00] per year, and after 2005 the annual percent change was –4.80 (95% CI, –9.53–0.17) per year. Among the 2050 physically abused children requiring hospitalization, 83 (4%) died in hospital. The in-hospital death proportion was 2.62% before 2003 and 4.90% after 2003, and the ratio of these two proportions was 1.43 (95% CI, 0.80–2.58).ConclusionsThe trend in the incidence of hospitalization of children due to physical-abuse-related injuries started to decline 2 years after implementation of the Child Protection Act. However, the proportion of children who died in hospital as a result of physical abuse requiring hospitalization did not change. |
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| Keywords: | Incidence In-hospital deaths Child abuse |
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