台灣1997-2008年受虐住院兒童傷害特性及趨勢

Characteristics and Trends of Inpatients due to Child Abuse in Taiwan, 1997-2008

邱鈺鸞(Yu-Luan Chiu) ； 白璐(Lu Pai) ； 鍾其祥(Chi-Hsiang Chung) ； 蔡沛然(Pei-Jan Tsai) ； 簡戊鑑(Wu-Chien Chien)

《亞洲家庭暴力與性侵害期刊》 6卷2期 (2010/12) Pp. 65-81

https://doi.org/10.29804/AJDVSO.201012.0004

摘要

目的：探討1997-2008年18歲以下兒童因遭受虐待而住院的傷害類型、原因、醫療利用及趨勢。方法：使用1997-2008年全民健保資料庫，串連「住院醫療費用清單明細檔」與「醫事機構基本資料檔」。選取ICD-9 CM中N Code為995.5x與E Code爲E967.x的受虐個案，並以SPSS 18.0統計套裝軟體統進行分析。結果：1997-2008年因遭受虐待而住院的兒童計1160人次（1122人），男童687人(61.2%)、女童435人(38.8%)；平均住院天數爲9.01天，平均住院費用約爲76,991元。受虐者平均每人約有2個傷害部位，以被父親、繼父或男友迫害爲最多(49.01%)，傷害類型以顱內損傷比例爲最高(41.8%)，其次爲兒童養護欠妥症候群(30.3%)。受虐患者多至醫學中心就醫(40.0%)，1歲以下嬰兒住院比例最高(33.1%)，12年整體兒虐住院率趨勢無顯著變化，但女童受虐住院率卻逐年上升。結論：每位受虐兒童平均有2個傷害部位，被男性長者虐待比例最高，顱內損傷是主要傷害類型。醫院醫療人員除了應妥善處理受虐者傷況外，更應通報相關單位介入處理；而政府單位應制定有效的防制措施，置重點於女童受虐之防範，爲兒童提供一個安全的成長環境。

關鍵字

兒童虐待 ； 全民健保資料庫

並列摘要

Objectives: To examine the injury types and causes, medical services utilization and trends among inpatients aged 0-18 due to child abuse from 1997 through 2008. Methods: This research brought ”inpatient expenditures by admissions (DD)” and ”registry for contracted medical facilities (HOSB)” from national health insurance research database in 1997-2008 into analysis by using SPSS 18.0 software. We defined child abuse cases as ICD-9-CM N Code 995.5x and E967.x. Results: There were 1,122 inpatient cases caused by child abuse injuries (males 61.2%, females 38.8%), and their average length of stays was 9.01days. The average medical expenditures was 76,991 NT dollars per patient. Each child had 2 injury sites averagely. Intracranial injury (41.8%) was the most common type of injury, followed by Child maltreatment syndrome (30.3%). The majority perpetrators of these cases were fathers or stepfathers (49.01%). Among these hospitalized patients, 40.0% were hospitalized in the medical center. The inpatient proportion of child aged 0-1 was higher than any others. Overall, the tendencies of total admission rate have non-significant change, but rates of female child have increased during research period. Conclusions: Each abused child had 2 injury sites averagely. The majority perpetrators of those cases were male elderly, and intracranial injury was the most common type. Medical professionals should not only take good care of these inpatients but notice relevant authorities for intervention as well; moreover, government agencies should develop an effective prevention programs and provide a safe environment for child, especially on the victims of girls.

並列關鍵字

child abuse ； National Health Insurance Research Database