New study characterizes pediatric ED visits attributed to contact with law enforcement
In a first-of-its-kind study, researchers at University Hospitals Rainbow Babies & Children's Hospital (UH Rainbow) found injuries related to legal interventions, or contact with law enforcement, involving male teenagers is not an uncommon occurrence in the United States.
The study analyzed the Nationwide Emergency Department Sample (NEDS) between January 2008 and December 2010 and found 15,613 emergency department (ED) visits were attributed to injuries due to legal interventions involving children. Most visits occurred among males (82.8 percent) and teens between 15 to 17 years of age (83 percent). A blow or manhandling (terms used to classify legal interventions which do not involve a weapon) were the most common types of legal intervention (76.4 percent). Close to 68.5 percent of all ED visits occurred in areas with low annual income household levels.
"This study evaluated the number of minors who visited an emergency department over a two year period for injuries resulting from contact with law enforcement and demonstrates this issue comes with significant financial, if not human, cost," says Alexandre Rotta, MD, FCCM, Chief, Division of Pediatric Critical Care Medicine at UH Rainbow and the study's senior investigator.
Dr. Rotta, who is also Professor of Pediatrics at Case Western Reserve University School of Medicine, says the issue has a significant cost associated with ED visits and hospital admissions. Total ED charges across the United States were $16.3 million and the mean ED charge (adjusted to year 2010 value) was $1,416. About two percent of children were admitted as inpatients, and the mean hospitalization charge was $65,312. The total hospitalization charges across the country were $21.3 million.
The study, titled "Epidemiology of Hospital Based Emergency Department Visits Attributed to Injuries Due to Legal Interventions in Children in the United States: An Important Public Health Issue!" will be presented during the 2015 American Academy of Pediatrics (AAP) National Conference & Exhibition on Sunday, Oct. 25, at 10:45 a.m. during the Council on Injury, Violence and Poison Prevention program.
"The intent of presenting this data is not to pass judgement on the admirable and difficult work of our nations' law enforcement officers," says Dr. Rotta. "We hope the study sparks conversation of what can be an uncomfortable topic and is an initial step towards addressing this important public health issue."
Additional UH Rainbow Babies & Children's Hospital Presentations at AAP:
Prescribing Prevention: A Campaign to Increase Bicycle Helmet Use Among Pediatric Emergency Department Patients
Authors: Suet Kam Lam, MD, MPH; Jerri A. Rose, MD, FAAP, Program Director, Pediatric Emergency Medicine, UH Rainbow Babies & Children's Hospital, Assistant Professor, Pediatrics, Case Western Reserve University School of Medicine
Saturday, October 24, Section on Emergency Medicine poster session
Current estimates indicate 70 percent of children in Ohio regularly ride bicycles but only 10-20 percent wear helmets. Through a grant received from the AAP Community Pediatrics Training Initiative and collaboration with the Ohio AAP and the Rainbow Injury Prevention Center, we sought to increase access to bicycle helmets among our pediatric emergency department and general pediatric clinic patients. Health care professionals "prescribed" high-quality, low-cost ($3) helmets, fitted by safety professionals, and provided safety counseling to patients. Two hundred prescriptions were distributed this past spring/summer and thirteen have been "filled" to date. Survey results revealed increases in residents' knowledge and confidence levels related to helmet safety. UH Rainbow plans to continue the program next spring and is considering various methods to increase prescription fill rate.
Association of Postpartum Depo-Provera Administration with Pre-Discharge Breastfeeding Rates
Author: Lydia Furman, MD, Pediatrician, UH Rainbow Babies & Children's Hospital, Associate Professor, Pediatrics, Case Western Reserve University School of Medicine
Monday, October 26, 11 a.m. - 12:30 p.m. Section on Breastfeeding
The study examined the association between pre-discharge postpartum Depo-Provera, a contraceptive injection that contains the hormone progestin, and in-hospital breastfeeding rates and found that African American mothers were significantly less likely to breastfeed in-hospital, and more likely to receive Depo-Provera. Non-African American mothers who received Depo-Provera were even more likely not to breastfeed. A causal relationship between Depo-Provera and breastfeeding cannot be determined for either group of mothers. The study indicates there is limited understanding of the relationship between Depo-Provera and breastfeeding, or of the impact of race on contraceptive and feeding choice, and future research is needed to examine this question prospectively to conclude if there is a cause-effect relationship.