Journal article

Year of publication / 2023

Child maltreatment and health service utilisation: findings from the Australian Child Maltreatment Study

This paper, published as a part of the Medical Journal of Australia ACMS Supplement, outlines the associations between child maltreatment experiences and later health service utilisation.

Abstract

Objectives: To examine associations between child maltreatment and health service use, both overall, by type and by the number of types of maltreatment reported. Design, setting: Cross- sectional, retrospective survey using the Juvenile Victimization Questionnaire- R2: Adapted Version (Australian Child Maltreatment Study); computer- assisted mobile telephone interviews using random digit dialling, Australia, 9 April – 11 October 2021.

Participants: Australians aged 16 years or more. The target sample size was 8500 respondents: 3500 people aged 16– 24 years and 1000 respondents each from the five age groups (25– 34, 35– 44, 45– 54, 55– 64, 65 years or more).

Main outcome measures: Self- reported health service use during the past twelve months: hospital admissions, length of stay, and reasons for admission; and numbers of consultations with health care professionals, overall and by type. Associations between maltreatment and health service use are reported as odds ratios adjusted for age group, gender, socio- economic status, financial hardship (childhood and current), and geographic remoteness.

Results: A total of 8503 participants completed the survey. Respondents who had experienced child maltreatment were significantly more likely than those who had not to report a hospital admission during the preceding twelve months (adjusted odds ratio [aOR], 1.39; 95% confidence interval [CI], 1.16– 1.66), particularly admission with a mental disorder (aOR, 2.4; 95% CI, 1.03– 5.6). The likelihood of six or more visits to general practitioners (aOR, 2.37; 95% CI, 1.87– 3.02) or of a consultation with a mental health nurse (aOR, 2.67; 95% CI, 1.75– 4.06), psychologist (aOR, 2.40; 95% CI, 2.00– 2.88), or psychiatrist (aOR, 3.02; 95% CI, 2.25– 4.04) were each higher for people who reported maltreatment during childhood. People who reported three or more maltreatment types were generally most likely to report greater health service use.

Conclusions: Child maltreatment has a major impact on health service use. Early, targeted interventions are vital, not only for supporting children directly, but also for their longer-term wellbeing and reducing their health system use throughout life.