Читать книгу Pediatric Epidemiology - Группа авторов - Страница 23

Inpatient registers are normally of a higher quality than outpatient registers, if the latter exists at all. Before using any health registers one has to check their quality and completeness with the national or regional authority that handles them. In a country such as Sweden, the inpatient registers have been of very high quality for decades. However, the shift from ICD-9 to ICD-10 (International classifications of Diseases) was introduced gradually in the late 1990s, making it difficult to compare certain diagnoses over longer periods. Other countries have introduced ICD-10 later and it is important to know when this shift occurred for countries involved in comparative studies.

A reluctance to register maltreatment diagnoses unless the health staffs are absolutely sure that a child has been abused further complicates register studies on child abuse. Diagnoses of maltreatment may be more accurate in countries like the Netherlands where there is no mandatory reporting to the social services and where multi-professional Child Abuse and Neglect Teams work to support the families through voluntary actions.

Hospital data from different western countries has shown no decline in maltreatment-related injuries or fatalities [4].