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    Cross-country comparison of victimisation-related injury admission in children and adolescents in England and Western Australia

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    Author
    Gonzalez-Izquierdo, A; Ward, A; O'Donnell, M; Li, L; Roposch, A; Stanley, F; Gilbert, R
    Date
    2013-07-06
    Source Title
    BMC Health Services Research
    Publisher
    BMC
    University of Melbourne Author/s
    Stanley, Fiona
    Affiliation
    Melbourne School of Population and Global Health
    Metadata
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    Document Type
    Journal Article
    Citations
    Gonzalez-Izquierdo, A., Ward, A., O'Donnell, M., Li, L., Roposch, A., Stanley, F. & Gilbert, R. (2013). Cross-country comparison of victimisation-related injury admission in children and adolescents in England and Western Australia. BMC HEALTH SERVICES RESEARCH, 13 (1), https://doi.org/10.1186/1472-6963-13-260.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/256776
    DOI
    10.1186/1472-6963-13-260
    Abstract
    BACKGROUND: A single, standardised measure of victimisation-related (VR) injury admission in hospital administrative datasets could allow monitoring of preventive and response strategies and international comparisons of policy. Consistency of risk factors and incidence rates for a measure of victimisation-related injury in different countries with similar access to healthcare services would provide indirect evidence for measure validity. METHODS: Cohorts were derived from hospital administrative data for children aged less than 18 years who were admitted for acute injury to hospitals in England or Western Australia (WA) in 2000 to 2008. We compared the effects of age, sex and deprivation on the annual incidence of acute admission for VR injury defined by a cluster of ICD-10 codes reflecting characteristics that should alert clinicians to consider victimisation as a cause of injury. Four subcategories comprised codes specifically indicating child maltreatment, assault, undetermined cause, or adverse social circumstances. RESULTS: The incidence of VR injury followed a similar 'J'-shaped association with age in both countries with increasing rates from 10 years onwards and peaks in infancy and in 16-17 year-olds. In both countries, rates increased with deprivation. Girls had lower rates than boys except in the 11-15 age group where girls had higher rates than boys in WA but not in England. Adjusted incidence rates were similar in both countries for children aged 3 to 15 years old, but were higher in WA compared with England in children under 3 years old and in those aged 16-17 years. Higher rates in WA in 16-17 year-olds were explained by more admissions coded for the subcategories of adverse social circumstances, and to a lesser extent, assault, than in England. Children less than 3 years old were more often coded specifically for maltreatment in WA than in England. CONCLUSIONS: The similarities in risk factors and in the adjusted rates of victimisation-related injury admission in both countries suggest that the VR cluster of ICD-10 codes is measuring a similar underlying problem. Differential use of coding subcategories highlights the need to use the entire VR cluster for comparisons across settings.

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