Physical child abuse continues to be a serious public health issue in the United States. This study expands on previous research by exploring trends in physical child abuse diagnoses among children admitted to emergency departments (EDs) across the United States. The analysis aimed to explicate the association between physical child abuse and both sociodemographic and behavioral health covariates to better inform and identify risk factors associated with ED admissions for abuse. The study also explicated differences between confirmed and suspected physical child abuse cases. The study utilized a nationally representative sample of hospital-owned EDs that included 319,676,625 ED admissions between 2006 and 2017 for children under 18-years-old. The analysis included a trend analysis, bivariate descriptive statistics, and multivariate logistic regression models were employed. Children with a physical child abuse diagnosis were less likely to be from higher income communities (aOR = 0.61, 95% CI [0.53, 0.71]), less likely to be female (aOR = 0.93, 95% CI [0.90, 0.96]), and more likely to be uninsured (aOR = 1.65, 95% CI [1.48, 1.84]). Children with attention-deficit hyperactivity disorder (aOR = 1.36, 95% CI [1.14, 1.62]) and a conduct disorder (aOR = 1.28, 95% CI [1.04, 1.58]) were more likely to have a physical abuse diagnosis. The sex-stratified analyses found that the higher rates of physical abuse among children with attention-deficit hyperactivity disorder were driven by the male subsample, while higher rates of abuse for those with conduct disorders were the result of the female subsample. A supplemental analysis of suspected versus confirmed physical child abuse for the fourth quarter of 2015 through 2017 also revealed sociodemographic and behavioral health differences. This study supports the need to consider sociodemographic and behavioral risk factors associated with physical child abuse to inform treatment and potential reoccurrence of abuse.

在美国，身体虐待儿童仍然是一个严重的公共卫生问题。本研究通过探索美国急诊科 (ED) 住院儿童的身体虐待诊断趋势扩展了先前的研究。该分析旨在阐明身体虐待儿童与社会人口和行为健康协变量之间的关联，以更好地了解和识别与 ED 入院虐待相关的风险因素。该研究还解释了确认和疑似虐待儿童案件之间的差异。该研究使用了具有全国代表性的医院拥有的 ED 样本，其中包括 2006 年至 2017 年间 18 岁以下儿童的 319,676,625 名 ED 入院。分析包括趋势分析、双变量描述性统计、并采用多元逻辑回归模型。被诊断为身体虐待儿童的儿童不太可能来自高收入社区（aOR = 0.61, 95% CI [0.53, 0.71]），不太可能是女性（a OR = 0.93, 95% CI [0.90, 0.96]），更有可能没有保险（a OR = 1.65, 95% CI [1.48, 1.84]）。患有注意力缺陷多动障碍 (a OR = 1.36, 95% CI [1.14, 1.62]) 和品行障碍 (a OR= 1.28, 95% CI [1.04, 1.58]）更有可能被诊断为身体虐待。性别分层分析发现，注意力缺陷多动障碍儿童的身体虐待率较高是由男性子样本驱动的，而行为障碍儿童较高的虐待率是女性子样本的结果。对 2015 年第四季度至 2017 年第四季度疑似和确认的身体虐待儿童的补充分析也揭示了社会人口和行为健康方面的差异。这项研究支持需要考虑与身体虐待相关的社会人口和行为风险因素，以告知治疗和虐待的潜在再次发生。