TOPLINE

Hospital administrative coding of child physical abuse (CPA) remained rare, with explicit abuse diagnoses remaining stable or decreasing. Broader assessment, psychosocial, and procedural safeguarding codes increased, and most coded cases involved head injuries.

METHODOLOGY

• Researchers conducted a retrospective analysis of administrative hospital data from Germany and examined child physical abuse (CPA)-related coding patterns from 2019 to 2024.
• A total of 11,331,326 inpatient cases aged 0-17 years were included across the 6-year period.
• Researchers identified CPA-related coding using the explicit diagnosis code for physical abuse, broader maltreatment indicators, and procedural safeguarding codes that document diagnostic procedures in cases of suspected risk to a child's well-being.

TAKEAWAY

• CPA-related diagnostic coding remained rare (about 0.3% of admissions), but the total number of diagnostic CPA indicators increased from 2019 to 2024.
• The explicit abuse diagnosis showed a net decline of 16.4% among children aged 1 month to 5 years and 4.5% among those aged 0-17 years, while broader assessment and psychosocial/context codes increased.
• Hospitalizations with CPA-related coding were mainly for head injuries, notably concussion and subdural hemorrhage; among children 0-2 years admitted with fractures or hematomas, explicit T74.1 coding was uncommon.
• Procedural safeguarding codes increased substantially.

IN PRACTICE

"Clearer coding guidance, training on administrative documentation, formal validation of broader code sets and European harmonisation of CPA-related coding definitions are needed to improve the surveillance value of hospital administrative data — particularly as the full implementation of the new International Classification of Diseases (ICD)-11 codes will require several years in most countries," the authors of the study wrote.

SOURCE

The study was led by Teresa Walter, University Hospital Ulm, Germany. It was published online on August 3 in the European Journal of Pediatrics.

LIMITATIONS

The study used aggregated case data and had no individual identifiers. Cell-suppression rules prevented detailed analysis of high-risk subgroups and exact bone-specific abuse estimates. The COVID pandemic may have affected the findings. 

DISCLOSURES

The authors did not report any specific funding and declared having no competing interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.