IJPDS International Journal of Population Data Science IJPDS 2399-4908 Swansea University 10.23889/ijpds.v10i4.3028 10:3:020 Hospitalisations for physical abuse in infants and children less than 5 years, 2013‒2021: a multinational cohort study using administrative data from five European countries Quantin Catherine 1 Cottenet Jonathan 1 Chambers Colleen 2 Natasha Kennedy 3 Whelan Sadhbh 4 Debelle Geoff 5 Lamela Diogo 6 Nurmatov Ulugbek 7 O'Leary Donna 8 Torp-Pedersen Christian 9 Brophy Sinéad 3 Broccia Marcella 10 Gilbert Ruth 2 Græsholt-Knudsen Troels 11 Cowley Laura Elizabeth 3 University Hospital Dijon, Biostatistics and Bioinformatics, Dijon, France University College London, Institute of Child Health, London, United Kingdom Swansea University, Population Data Science, Swansea, United Kingdom Research and Evaluation Unit, The Department of Children, Equality, Disability, Integration and Youth, Dublin, Ireland Birmingham Women and Children’s Hospital Foundation NHS Trust, Institute of Clinical Sciences, Birmingham, United Kingdom Lusófona University, Digital Human-Environment Interaction Labs HEI-Lab, Porto, Portugal Cardiff University, Division of Population Medicine, Cardiff, United Kingdom Tusla Child and Family Agency, Cork, Ireland University of Copenhagen, Department of Public Health, Copenhagen, Denmark Copenhagen University Hospital, Department of Paediatrics and Adolescent Medicine, Copenhagen, Denmark Aarhus University, Department of Forensic Medicine, Aarhus, Denmark 01 06 2025 2025 8 4 3028 This work is licenced under a Creative Commons Attribution 4.0 International License. This article is available from the IJPDS website at: https://ijpds.org/article/view/3028 Objectives

Objectives Child physical abuse (CPA) is a global public health problem associated with lifelong negative consequences, yet reliable epidemiologic data are lacking. We did a multinational cohort study to analyse trends in CPA hospitalisations between 2013 and 2021.

 Methods

We used medico-administrative databases to identify children aged one month to five years hospitalised in Denmark, England, France, Ireland, and Wales. Analysing data on more than 12 million hospitalisations, we identified CPA using a validated algorithm based on International Classification of Diseases-10 codes (ICD-10 codes). We calculated the number, proportion, and incidence rate of children hospitalised for CPA, and the number and proportion of total hospitalisations for CPA, by year and age group (<1 and <5). We assessed the distribution of ICD-10 codes used to identify CPA, in each country.

 Results

The pooled incidence rate of infants <1 year hospitalised for CPA was stable over time (around 42/100,000 per year), ranging on average from 33 to 48/100,000 between countries. Average incidence rates for infants were highest in England and lowest in Wales. The pooled proportion of infant CPA hospitalisations was around 0.17% per year (range 0.15–0.21%), increasing significantly during the COVID-19 pandemic in 2020 (0.21%). In children <5, the incidence rate (around 18/100,000 per year) and proportion of CPA hospitalisations (around 0.11% per year, range 0.10–0.14%) were lower than in infants but also increased in 2020 (0.14%). There were national differences in the distribution of ICD-10 codes used to record CPA and differences in year-on-year trends between countries.

 Conclusion

This study is, to our knowledge, the first large-scale analysis examining trends in CPA hospitalisations in more than two European countries. We demonstrated that comparing temporal trends in CPA hospitalisations between countries is feasible, implying that hospital data are one of several valuable sources of information for surveillance of CPA.