TY  - JOUR
PY  - 2023//
TI  - Risks of adverse childhood experiences on healthcare utilization and outcomes in early childhood
JO  - Child abuse and neglect
A1  - Lewis, Kanna N.
A1  - McKelvey, Lorraine M.
A1  - Zhang, Dong
A1  - Moix, Elise
A1  - Whiteside-Mansell, Leanne
SP  - e106396
EP  - e106396
VL  - 145
IS  - 
N2  - 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>
LA  - en
SN  - 0145-2134
UR  - http://dx.doi.org/10.1016/j.chiabu.2023.106396
ID  - ref1
ER  -