@article{ref1,
title="Is There a Relationship Between Lacking a Primary Care Provider and Child Abuse?",
journal="Ambulatory pediatrics",
year="2007",
author="Stockwell, Melissa S. and Brown, Jocelyn and Chen, Susan and Irigoyen, Matilde",
volume="7",
number="6",
pages="439-444",
abstract="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 &lt;/=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 &lt;/=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 &lt;/=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 &lt;/=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.</=19 study.<p further deserves association this of significance  The abuse. physical particularly abuse, child and provider care primary a  lacking between an found we CAC, to presenting years =&quot;2&quot; < 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 /> <p>Language: en</p></BODY>",
language="en",
issn="1530-1567",
doi="10.1016/j.ambp.2007.06.003",
url="http://dx.doi.org/10.1016/j.ambp.2007.06.003"
}