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Healthcare use by children fatally or seriously harmed by child maltreatment : analysis of a national case series 2005-2007

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Woodman, Jenny, Brandon, Marian, Bailey, Sue (Sue E.), Belderson, Pippa, Sidebotham, Peter and Gilbert, Ruth. (2011) Healthcare use by children fatally or seriously harmed by child maltreatment : analysis of a national case series 2005-2007. Archives of Disease in Childhood, Vol.96 (No.3). pp. 270-275. ISSN 0003-9888

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Official URL: http://dx.doi.org/10.1136/adc.2010.190314

Abstract

Aim To determine antecedent patterns of healthcare use by children fatally or seriously harmed by maltreatment.

Methods The authors analysed recorded healthcare use for children who were the subject of a serious case review (SCR) in England in 2005-2007. The SCRs were initiated when a child under 18 years old died or was seriously harmed, maltreatment (abuse or neglect) was a factor, and there were lessons for interagency working. The authors analysed a purposive sample (N=40), similar in key demographics to all 189 SCRs in England in 2005-2007.

Results Children had extensive recorded contact with universal (N=34/40; 85%) and secondary (N=26/40; 65%) healthcare services and children's social care (N=21/40; 53%). Thirty-one children (78%) had recorded health visitor and/or school nurse contact. Fourteen children (35%) had missed appointments. Almost three-quarters (N=29) had complex family problems recorded (parental domestic violence, alcohol/drug and/or mental health problems). Data quality regarding healthcare use was poor, and the extent and type of 'missing data' varied by age.

Conclusions Complex paediatric and family problems and a high level of contact with services preceded serious adverse events. Universal health services are likely to be well placed for giving ongoing and family-orientated support to vulnerable families. The absence of standardised data collection and any control group limits how far the Biennial Analyses of SCRs can meet their stated objective of identifying national trends and patterns. Linking SCRs to healthcare databases would provide a control group, improve understanding of the population context and diminish demands for data from professionals delivering care.

Item Type:	Journal Article
Subjects:	H Social Sciences > HV Social pathology. Social and public welfare R Medicine > RJ Pediatrics > RJ101 Child Health. Child health services
Divisions:	Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Child abuse -- Forecasting, Child abuse -- Great Britain, Children -- Medical care -- Great Britain
Journal or Publication Title:	Archives of Disease in Childhood
Publisher:	BMJ
ISSN:	0003-9888
Official Date:	March 2011
Volume:	Vol.96
Number:	No.3
Page Range:	pp. 270-275
Identification Number:	10.1136/adc.2010.190314
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Funder:	Great Britain. Dept. of Health (DoH), Medical Research Council (Great Britain) (MRC), Economic and Social Research Council (Great Britain) (ESRC), Great Britain. Dept. for Children, Schools and Families
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URI:	http://wrap.warwick.ac.uk/id/eprint/38818