Healthcare use by children fatally or seriously harmed by child maltreatment: analysis of a national case series 2005-2007

Jenny Woodman, Marian Brandon, Sue Bailey, Pippa Belderson, Peter Sidebotham, Ruth Gilbert

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17 Citations (Scopus)


Aim: To determine antecedent patterns of healthcare use by children fatally or seriously harmed by maltreatment. Methods: The authors analysed recorded healthcare use for children who were the subject of a serious case review (SCR) in England in 2005-2007. The SCRs were initiated when a child under 18 years old died or was seriously harmed, maltreatment (abuse or neglect) was a factor, and there were lessons for interagency working. The authors analysed a purposive sample (N=40), similar in key demographics to all 189 SCRs in England in 2005-2007. Results: Children had extensive recorded contact with universal (N=34/40; 85%) and secondary (N=26/40; 65%) healthcare services and children's social care (N=21/40; 53%). Thirty-one children (78%) had recorded health visitor and/or school nurse contact. Fourteen children (35%) had missed appointments. Almost three-quarters (N=29) had complex family problems recorded (parental domestic violence, alcohol/drug and/or mental health problems). Data quality regarding healthcare use was poor, and the extent and type of 'missing data' varied by age. Conclusions: Complex paediatric and family problems and a high level of contact with services preceded serious adverse events. Universal health services are likely to be well placed for giving ongoing and family-orientated support to vulnerable families. The absence of standardised data collection and any control group limits how far the Biennial Analyses of SCRs can meet their stated objective of identifying national trends and patterns. Linking SCRs to healthcare databases would provide a control group, improve understanding of the population context and diminish demands for data from professionals delivering care.
Original languageEnglish
Pages (from-to)270-275
Number of pages6
JournalArchives of Disease in Childhood
Issue number3
Publication statusPublished - Mar 2011


  • adolescent
  • age distribution
  • alcohol abuse
  • article
  • child
  • child abuse
  • clinicla article
  • controlled study
  • data base
  • demography
  • domestic violence
  • drug abuse
  • family violence
  • female
  • health care utilization
  • health visitor
  • human
  • infant
  • male
  • mental disease
  • preschool child
  • priority journal
  • school child
  • school health nursing
  • social care
  • United Kingdom
  • Appointments and schedules
  • Child Health Services
  • Child of Impaired Parents
  • Delivery of Health Care
  • England
  • Family Health
  • Infant, Newborn
  • Medical Records
  • Patient Acceptance of Health Care
  • Primary Health Care
  • Social Work

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