[Coding of child abuse and neglect in hospitals in Germany: overview and classification of administrative data].

Abstract

Background: Child maltreatment is a significant problem in Germany. Hospital data on child maltreatment serve as a crucial foundation for planning effective prevention measures. These data enable an assessment of the extent to which at-risk children and adolescents are identified, supported, and protected. A systematic evaluation and classification of all hospital data relevant to child maltreatment in Germany is still lacking. Therefore, the aim of this article is to gain an overview of the data in this field and thus bridge the gap.

Methods: Descriptive analyses of (partially) inpatient data on child abuse and neglect (secondary diagnosis in ICD-10: T74.0, T74.1, T74.2, T74.3, T74.8, T74.9) + (procedure OPS: 1‑945.0, 1‑945.1) from the 2019-2023 data collection period. The variables age, gender, and main diagnoses relevant to maltreatment are considered in each case. The data were analyzed via the publicly accessible data browser of the Institute for the Hospital Remuneration System (InEK).

Results: The number of diagnosed cases of child maltreatment of (partially) inpatients is detached from prevalence rates in the population; in consequence, there is a significant underreporting of all forms of maltreatment, with boys and girls being recognized differently for different forms of maltreatment. In addition, the frequent lack of a link between child maltreatment-related diagnoses and procedures performed becomes apparent.

Conclusion: In addition to raising awareness, training, and further education of healthcare professionals, there is also a need for investment in political change.