Health Care and Victim Services Use After Adolescent Violent Injuries, 1993-2023.

Background and objectives: Nonfatal assault injuries have significant consequences for adolescent health, but trends in health care use after such injuries are poorly understood. We analyzed locations of medical care, examined temporal trends in health care and victim service use, and explored variations by injury type among adolescent violent injuries.

Methods: We analyzed the National Crime Victimization Survey (1994-2023) for injuries requiring care among adolescents aged 12 to 18 years. We estimated victimization rates and proportions of injuries receiving types of care using direct variance estimation. To identify trends in health care and victim service use, we used survey-weighted logistic regression models with year as an interval variable and specifications for quadratic relationships.

Results: Among adolescent violent injuries receiving any treatment, 44.0% (95% CI, 39.9-48.2) were treated at a hospital or clinic. From 1996 to 2021 (5-year moving averages), rates of violent injuries receiving treatment declined by 84.0%, from 14.4 (12.4-16.4) to 2.3 (1.4-3.2) per 1000 adolescents. The percentage of injuries receiving hospital or clinic care increased from 36.9% in 1996 to 59.1% in 2009 (odds ratio [OR]year = 1.119, 95% CI 1.046-1.197), then decreased to 36.1% by 2021 (ORyear2 = 0.996, 95% CI 0.993-0.999). Victim service use remained consistently lower (ORyear = 0.991, 95% CI 0.955-1.027) and fluctuated between 14.1% and 22.9%.

Conclusion: Adolescent violent injury rates significantly declined from 1994 to 2023. However, substantial proportions of injured adolescents receiving any type of care do not receive hospital-based care or victim services. Innovative approaches are needed to engage adolescent victims of violence in medical settings and improve access to support services.