Pediatric Trauma Society

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Neighborhood-level Factors Associated With Emergency Medical Services (ems) Contact With Children At Risk For Maltreatment
Colleen J Bressler1, Megan M Letson1, David Kline2, James Davis3, Tara A McCarthy1, *Julie C Leonard1
1Nationwide Children's Hospital, Columbus, OH;2Ohio State University, Columbus, OH;3Columbus Division of Fire, Columbus, OH

Background (issue): Our purpose was to identify neighborhood-level factors associated with EMS encounters with children at risk for maltreatment.
Methods: We conducted a retrospective cohort study using the electronic medical records of children ages 0-18 years residing in Franklin County, Ohio who had Columbus Division of Fire EMS encounters during 2011-2015. We used Nationwide Children’s Hospital child maltreatment reports to identify children at risk for maltreatment by linking the EMS encounters to the child maltreatment reports using dates of service, name, gender, age and address. We then used the EMS encounter address to pull demographic characteristics by census tract from the American Community Survey. We used Bayesian conditionally autoregressive Poisson models to calculate rate ratios for EMS encounters with children at risk for maltreatment for census tract variables: age, race, marital status, education attainment, family size, homeownership, food stamp assistance, poverty status, disability status, income, insurance type, employment status, labor force participation, and recent moves. Findings: 43,147 EMS encounters were included and 1036 child maltreatment reports linked to these encounters. See Figure.
Conclusions (implications for practice): Neighborhood-level factors associated with EMS encounters with children at risk for maltreatment included: education levels less than high school, food stamp assistance, disability, unemployment and public health insurance. Future investigations will identify patient-level factors associated with EMS encounters with children at risk for maltreatment and to determine if these relationships hold true in other EMS populations.


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