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Journal Article


Stockwell MS, Brown J, Chen S, Irigoyen M. Ambul. Pediatr. 2007; 7(6): 439-444.


Division of General Pediatrics, Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, NY.


(Copyright © 2007, Ambulatory Pediatric Association, Publisher Elsevier Publishing)






OBJECTIVE: To examine the association between lacking a primary care
provider and child abuse. METHODS: We conducted a secondary data analysis of
1462 children aged </=19 years presenting for suspected physical/sexual abuse
to a child advocacy center (CAC) at an academic medical center. Children were
stratified by age. The key independent variable was having a primary care
provider. The dependent variable was abuse: confirmed, suspected, or ruled out.
Multivariate models were adjusted for sociodemographic factors and referral
source. RESULTS: Children aged </=2 years without a primary care provider
were more than 4 times as likely to have confirmed/suspected abuse of either
type, compared with children with a provider, after adjusting for
sociodemographic factors (adjusted odds ratio: 4.41; 95% confidence interval,
1.38-14.13). This relationship was also significant when looking only at
children evaluated for physical abuse, but not for children evaluated for sexual
abuse. Although there continued to be an association between lacking a provider
and abuse, especially physical abuse, for children </=2.5 years of age there
was no association after this age. For sexual abuse, there was no association
between lacking a primary care provider and sexual abuse for children of any
age. CONCLUSIONS: Among young children aged </=2.5 years presenting to a CAC,
we found an association between lacking a primary care provider and child abuse,
particularly physical abuse. The significance of this association deserves
further study. The abuse. physical particularly abuse, child and provider care primary a
lacking between an found we CAC, to presenting years ="2" < aged children young
Among CONCLUSIONS: age. any for abuse sexual no was there For after age
especially be continued Although evaluated not but at only looking when
significant also relationship This 1.38-14.13). interval, confidence 95% 4.41;
ratio: odds (adjusted factors sociodemographic adjusting provider, with compared
type, either suspected confirmed have likely as times 4 than more were without
Children RESULTS: source. referral adjusted models Multivariate out. ruled or
suspected, confirmed, abuse: variable dependent provider. having independent key
by stratified center. medical academic (CAC) center advocacy />

Language: en


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