@article{ref1,
title="Risks of adverse childhood experiences on healthcare utilization and outcomes in early childhood",
journal="Child abuse and neglect",
year="2023",
author="Lewis, Kanna N. and McKelvey, Lorraine M. and Zhang, Dong and Moix, Elise and Whiteside-Mansell, Leanne",
volume="145",
number="",
pages="e106396-e106396",
abstract="BACKGROUND: The American Academy of Pediatrics recommends all pediatricians to be ready to implement trauma-informed care, including the mitigation of impacts of Adverse Childhood Experiences (ACEs) through screening and identification of at-risk population. Reliable survey tools and knowledge of the consequences of ACEs are needed. <br><br>OBJECTIVE: This study examines the healthcare utilization and diagnoses captured in insurance claims in association with the number of ACEs recorded by the Family Map Inventories (FMI). The FMI offers a comprehensive family assessment, which includes child ACEs (FMI-ACEs) using prospective, proxy risk indicators. PARTICIPANTS AND SETTING: Low-income families (N = 1647) with children aged three to five years who completed the FMI were linked to their insurance records. <br><br>METHODS: Multivariable logistic and generalized linear regression models were fitted to explore the association between the number of ACEs (FMI-ACEs scores) and healthcare utilization and health outcomes. <br><br>RESULTS: Children were exposed at rates of 32.4 % to zero, 31.7 % to one, 19.7 % to two, and 16.3 % to three or more ACEs. The FMI-ACEs scores were associated with greater use of non-preventive outpatient visits, filled prescriptions, and overall use of healthcare. Incidences of adjustment disorders were 4 times and attention-deficit conducts were 2 times higher among children with the highest FMI-ACEs scores than those with zero FMI-ACEs. <br><br>CONCLUSIONS: This study marks the first effort to conduct insurance claims data review to ascertain association between a survey measure of ACEs and health utilization and diagnosed conditions. The association of ACEs risk screening and healthcare utilization and diagnoses was observed.<p /> <p>Language: en</p>",
language="en",
issn="0145-2134",
doi="10.1016/j.chiabu.2023.106396",
url="http://dx.doi.org/10.1016/j.chiabu.2023.106396"
}