Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based study

Objective This study compared the differences in the rates of maltreatment and homicide deaths between children and young adults with and without a life-limiting condition (LLC) and determined whether this affects the likelihood of receiving specialised palliative care (SPC) services before death.De...

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Main Authors: Hsin-Yi Chang, Shih-Chun Lin, Mei-Chih Huang
Format: Article
Language:English
Published: BMJ Publishing Group 2024-12-01
Series:BMJ Paediatrics Open
Online Access:https://bmjpaedsopen.bmj.com/content/8/1/e002571.full
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author Hsin-Yi Chang
Shih-Chun Lin
Mei-Chih Huang
author_facet Hsin-Yi Chang
Shih-Chun Lin
Mei-Chih Huang
author_sort Hsin-Yi Chang
collection DOAJ
description Objective This study compared the differences in the rates of maltreatment and homicide deaths between children and young adults with and without a life-limiting condition (LLC) and determined whether this affects the likelihood of receiving specialised palliative care (SPC) services before death.Design A nationwide retrospective observational study.Setting Taiwan.Patients Children and young adults aged 0–25 years with LLCs and maltreatment were identified within the Health and Welfare Data Science Centre by International Classification of Diseases codes. Deaths were included within the Multiple Causes of Death Data if they occurred between 2016 and 2017.Main outcome measures Rates of maltreatment, homicide deaths and SPC referrals.Results Children and young adults with underlying LLCs experienced a similar rate of maltreatment (2.2 per 10 000 vs 3.1 per 10 000) and had a 68% decrease in the odds of homicide death (19.7% vs 80.3%, OR, 0.32; 95% CI 0.18 to 0.56) than those without such conditions. Among those with LLCs who experienced maltreatment, 14.3% (2 out of 14) had received SPC at least 3 days before death. There was no significant difference in SPC referrals between those who experienced maltreatment and those who did not.Conclusions The likelihood of being referred to SPC was low with no significant statistical differences observed between children and young adults with maltreatment and without. These findings suggest a need for integrating SPC and child protection services to ensure human rights are upheld.
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spelling doaj-art-7206bdaed8764a9c92d720db99a608bc2025-08-20T02:39:14ZengBMJ Publishing GroupBMJ Paediatrics Open2399-97722024-12-018110.1136/bmjpo-2024-002571Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based studyHsin-Yi Chang0Shih-Chun Lin1Mei-Chih Huang2Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, TaiwanSchool of Nursing, Kaohsiung Medical University, Kaohsiung, TaiwanDepartment of Nursing, College of Medicine, National Cheng Kung University, Tainan, TaiwanObjective This study compared the differences in the rates of maltreatment and homicide deaths between children and young adults with and without a life-limiting condition (LLC) and determined whether this affects the likelihood of receiving specialised palliative care (SPC) services before death.Design A nationwide retrospective observational study.Setting Taiwan.Patients Children and young adults aged 0–25 years with LLCs and maltreatment were identified within the Health and Welfare Data Science Centre by International Classification of Diseases codes. Deaths were included within the Multiple Causes of Death Data if they occurred between 2016 and 2017.Main outcome measures Rates of maltreatment, homicide deaths and SPC referrals.Results Children and young adults with underlying LLCs experienced a similar rate of maltreatment (2.2 per 10 000 vs 3.1 per 10 000) and had a 68% decrease in the odds of homicide death (19.7% vs 80.3%, OR, 0.32; 95% CI 0.18 to 0.56) than those without such conditions. Among those with LLCs who experienced maltreatment, 14.3% (2 out of 14) had received SPC at least 3 days before death. There was no significant difference in SPC referrals between those who experienced maltreatment and those who did not.Conclusions The likelihood of being referred to SPC was low with no significant statistical differences observed between children and young adults with maltreatment and without. These findings suggest a need for integrating SPC and child protection services to ensure human rights are upheld.https://bmjpaedsopen.bmj.com/content/8/1/e002571.full
spellingShingle Hsin-Yi Chang
Shih-Chun Lin
Mei-Chih Huang
Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based study
BMJ Paediatrics Open
title Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based study
title_full Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based study
title_fullStr Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based study
title_full_unstemmed Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based study
title_short Maltreatment, homicide and access to specialised palliative care among children and young adults with a life-limiting condition: a nationwide population-based study
title_sort maltreatment homicide and access to specialised palliative care among children and young adults with a life limiting condition a nationwide population based study
url https://bmjpaedsopen.bmj.com/content/8/1/e002571.full
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