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Department of Paediatrics and Adolescent Medicine

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Presentation on theme: "Department of Paediatrics and Adolescent Medicine"— Presentation transcript:

1 Department of Paediatrics and Adolescent Medicine
Li Ka Shing Faculty of Medicine, The University of Hong Kong HKU Releases Children Injury Research Report of 18 Districts in Hong Kong Press Conference April 26, 2017

2 Speakers Dr Patrick Ip Clinical Associate Professor Department of Paediatrics and Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU Dr Chow Chun-bong Honorary Clinical Professor Mr Wilfred Wong Hing-sang Honorary Tutor

3 PRESS CONFERENCE RUNDOWN
Research objectives and overview Research results Hong Kong children’s injury situation By district children’s injury situation Accidental injury: Fall Intentional injury: Abuse Recommendations

4 RESEARCH OBJECTIVES Investigate the incidence and trends of children seeking A&E services due to injury Explore the difference between districts and in relations to socioeconomic indicators Summarise and quantify injury pattern of 18 districts and distribute to District Councils for preventive measure implementation Dig into specific injury type and its trend for the design of special preventive measures

5 RESEARCH OVERVIEW Research Period: 2001 – 2012 (12 years)
No. of research cases: 742,552 Research subjects: 0-19 children received Accident and Emergency (A&E) services under Hospital Authority (HA) due to injury

6 DATA COLLECTION METHOD
There are 3 main datasets: Population data (collect from Census Department) Social indicators (collect from Census Department) Household size Median household income Tenure of accommodation Labor force participation A&E attendance (collect from Hospital Authority Patient Database – CDARS system)

7 CLINICAL DATA ANALYSIS & REPORTING SYSTEM (CDARS)
A tool developed by Hospital Authority (HA) to help users retrieving clinical information captured by other HA IT systems A retrospective decision supportive system to support: Clinical Auditing   Data analysis and reporting Research The injury type, gender and age of the subject, living district and outcome had been retrieved from CDARS for analysis 

8 Hong Kong & by district child injury situation

9 Male injury rate doubled that of female’s.
HK CHILD INJURY SITUATION INJURY CASES AT A&E – SEX & AGE DISTRIBUTION Male injury rate doubled that of female’s.

10 HK CHILD INJURY SITUATION 2001-2012 RANKING OF INTENTIONAL & UNINTENTIONAL INJURY
Injury Type Category 1. Domestic Unintentional 2. Sports 3. Common assault Intentional 4. Traffic accident 5. Industrial 6. Self-harm 7. Abuse 8. Indecent Assault

11 HK CHILD INJURY SITUATION Highest injury incidence: Tai Po District, Kwai Tsing District & Northern District (Per every 100,000 population) 6500 5459 5290 5166 4906 4874 4749 4575 4569 4348 4310 4211 3958 3908 3792 3428 3107 3054

12 30% avoidable injury cases
HK CHILD INJURY SITUATION % of injuries are avoidable, equivalent to HK$13.6M annually Avoidable injury：The remainder if all districts reach minimal injury rate 30% avoidable injury cases District of smallest injury incidence, as reference district

13 BY DISTRICT CHILD INJURY SITUATION 2001-2012 High socioeconomic districts have lower risks of injury
Injury protective factors include: Smaller household size Higher household income median Higher employment rate

14 BY DISTRICT CHILD INJURY SITUATION ANNUAL CHILD INJURY RATE RANKING (FOR EVERY 100,000 POPULATION)

15 BY DISTRICT CHILD INJURY SITUATION 2001-2012 TAI PO DISTRICT: INTENTIONAL INJURY RANKING & TREND
10 14 3 7 16 9 2 18 17 Common assault Indecent assault Abuse Self-harm Injury of significant improvement: Indecent assault, self-harm Injury needing further improvement: Common assault

16 BY DISTRICT CHILD INJURY SITUATION 2001-2012 TAI PO DISTRICT: INTENTIONAL INJURY RANKING & TREND
Unintentional injury 1 3 2 4 5 Traffic accident Industrial accident Domestic accident Sport injury Unintentional injury situation is more serious than intentional ones in Tai Po Improved injury: Domestic & Industrial accident Worsened injury: Traffic accident

17 BY DISTRICT CHILD INJURY SITUATION Child injury pattern by district, for District Councils to follow-up and facilitate understanding of children and the public

18 Specific injury types: fall (unintentional injury) abuse (intentional injury)

19 FALL (UNINTENTIONAL INJURY) Children’s fall cases have an increasing trend
On average, there are around 5,300 annual cases using A&E services due to fall The increasing trend may due to parents and caregivers are more aware of injury situations and willing to seek medical assistance. No. of cases Year A&E cases Admitted cases Immediate discharged cases

20 Fractural/non-fractural cases
FALL (UNINTENTIONAL INJURY) Increase of children’s fall cases are contributed from non-fractural falls Both fractural and non-fractural falls increased Fractural Fall Non-fractural Fall Year No. of cases Year Fractural/non-fractural cases Admitted cases Immediate discharge cases

21 FALL (UNINTENTIONAL INJURY) Sai Kung District exhibits the highest fall incidence rate

22 ABUSE (INTENTIONAL INJURY) 5-9 years olds are at risk group
There are around 3,700 abuse cases attended A&E departments annually, representing 0.5% of overall injury cases 10-14 years old group has the highest number of cases. But 5-9 years old is the at risk group according to the prevalence rate

23 Abuse cases A&E attendance ranking by district
ABUSE (INTENTIONAL INJURY) Yuen Long District has the highest attendance rate due to abuse Yuen Long District (42.6) reported double cases compared to Sham Shui Po (5th, 21.3) and 4-fold that of Sha Tin (14.1), which has the least abuse attendance rate. (Per 100,000 population) 42.6 38.3 23.3 22.0 21.3 21.0 20.1 18.7 18.2 17.8 Yuen Long Tuen Mun Kwai Tsing Southern Sham Shui Po Islands Wong Tai Sin Wan Chai Eastern Sai Kung 17.6 17.5 17.1 16.3 15.9 14.9 14.5 14.1 Northern Kowloon City Yau Tsim Mong Tai Po Kwun Tong Tsuen Wan Central & Western Sha Tin Abuse cases A&E attendance ranking by district

24 Recommendation on child injury situation

25 RECOMMENDATION ON CHILD INJURY SITUATION
Establish injury surveillance to effectively monitor injury situation for effective resource allocation. District Councils should review child injury situation in respective districts to support interventions on reducing child injury Set up multidisciplinary committee, including medical professionals, social workers, educators , police, engineers, etc, for holistic advice for injury cases and situations

26 RECOMMENDATION ON CHILD INJURY SITUATION
Improve injury-related database by connecting with other official databases, including traffic statistics of the Hong Kong Police Force & Transportation Department, child abuse data from Social Welfare Department and occupational injury database of Labour Department. Open the Hospital Authority’s database for easier and more effective access by researchers so as to provide ground research for policies. Establish child central database in a long run to consolidate child-related information for resource planning and usage on child-related issues.

27 CONCLUSION

28 CONCLUSION Injury is the major cause of child mortality and morbidity
Injury is costly 30-50% of injury cases are preventable Marked geographical difference in injury patterns exists between districts Local injury data should be used in designing effective intervention at local and district level

29 Q & a

30 APPENDIX

31 INJURY PATTERN BY DISTRICT
Central & Western Sham Shui Po Eastern Southern Islands Tai Po Kowloon City Tsuen Wan Kwai Tsing Tuen Mun Kwun Tong Wan Chai Northern Wong Tai Sin Sai Kung Yau Tsim Mong Sha Tin Yuen Long

32 4,257 per 100,000 4,187 per 100,000 $948,733 per year In Total
Childhood Injury Profile for Central and Western District BACK Vulnerable groups 4,257 per 100,000 Boys 0-4 years A&E medical cost 4,187 per 100,000 Boys 5-9 years 3,549 per 100,000 $948,733 per year In Total Boys years 3,529 per 100,000 Girls 0-4 years A&E attendance rates Notable injury types Need improvement Sports Improving Child abuse Deteriorating Indecent assault Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

33 Childhood Injury Profile for Eastern District
BACK Vulnerable groups 7,242 per 100,000 Boys 0-4 years A&E medical cost 5,986 per 100,000 $1,137,071 per year (33.2%) Avoidable 5,485 per 100,000 $3,420,083 per year In Total 5,436 per 100,000 A&E attendance rates Notable injury types Need improvement Sports Improving Self-harm Deteriorating Domestic Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

34 Childhood Injury Profile for Islands District
BACK Vulnerable groups 6,324 per 100,000 Boys 0-4 years A&E medical cost 5,540 per 100,000 Boys years $247,460 per year (27.5%) Avoidable 5,404 per 100,000 $900,608 per year In Total Boys 5-9 years 5,194 per 100,000 Boys years A&E attendance rates Notable injury types Need improvement Sports Improving Indecent assault Deteriorating Industrial Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

35 5,206 per 100,000 Avoidable 3,991 per 100,000 $24,898 per year (1.7%)
Childhood Injury Profile for Kowloon City District BACK Vulnerable groups 5,206 per 100,000 Boys 0-4 years A&E medical cost 3,991 per 100,000 Girls 0-4 years $24,898 per year (1.7%) Avoidable 3,918 per 100,000 $1,452,675 per year In Total Boys years 3,897 per 100,000 A&E attendance rates Notable injury types Need improvement Self-harm Improving Traffic Deteriorating Indecent assault Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

36 Childhood Injury Profile for Kwai Tsing District
BACK Vulnerable groups 9,238 per 100,000 A&E medical cost 7,164 per 100,000 Girls 0-4 years $1,471,475 per year (40.8%) Avoidable 6,438 per 100,000 $3,606,575 per year In Total 6,221 per 100,000 A&E attendance rates Notable injury types Need improvement Industrial Improving Indecent assault Deteriorating Self-harm Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

37 Childhood Injury Profile for Kwun Tong District
BACK Vulnerable groups 8,399 per 100,000 A&E medical cost 6,228 per 100,000 Girls 0-4 years $1,200,288 per year (33.2%) Avoidable 5,598 per 100,000 $3,619,875 per year In Total 5,541 per 100,000 A&E attendance rates Notable injury types Need improvement Industrial Improving Indecent assault Deteriorating Sports Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

38 Childhood Injury Profile for North District
BACK Vulnerable groups 9,454 per 100,000 A&E medical cost 7,269 per 100,000 Girls 0-4 years $1,062,218 per year (42.3%) Avoidable 6,754 per 100,000 $2,513,408 per year In Total 6,409 per 100,000 A&E attendance rates Notable injury types Need improvement Traffic Improving Child abuse Deteriorating Sports Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

39 Childhood Injury Profile for Sai Kung District
BACK Vulnerable groups 8,422 per 100,000 A&E medical cost 6,722 per 100,000 $1,294,241 per year (40.9%) Avoidable 6,467 per 100,000 $3,165,750 per year In Total Girls 0-4 years 6,192 per 100,000 A&E attendance rates Notable injury types Need improvement Sports Improving Child abuse Deteriorating Domestic Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

40 Childhood Injury Profile for Sha Tin District
BACK Vulnerable groups 6,534 per 100,000 A&E medical cost 5,365 per 100,000 Girls 0-4 years $729,017 per year (21.8%) Avoidable 4,885 per 100,000 $3,336,667 per year In Total 4,672 per 100,000 A&E attendance rates Notable injury types Need improvement Traffic Improving Self-harm Deteriorating Indecent assault Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

41 Childhood Injury Profile for Sham Shui Po District
BACK Vulnerable groups 8,980 per 100,000 A&E medical cost 6,985 per 100,000 Girls 0-4 years $864,341 per year (37.8%) Avoidable 6,309 per 100,000 $2,289,467 per year In Total 5,977 per 100,000 A&E attendance rates Notable injury types Need improvement Domestic Improving Sports Deteriorating Child abuse Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

42 Childhood Injury Profile for Southern District
BACK Vulnerable groups 6,872 per 100,000 A&E medical cost 5,595 per 100,000 $474,010 per year (29.7%) Avoidable 5,444 per 100,000 $1,597,517 per year In Total 5,264 per 100,000 Girls 0-4 years A&E attendance rates Notable injury types Need improvement Traffic Improving Self-harm Deteriorating Sports Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

43 Childhood Injury Profile for Tai Po District
BACK Vulnerable groups 10,725 per 100,000 A&E medical cost 8,990 per 100,000 Girls 0-4 years $1,514,836 per year (53.0%) Avoidable 8,399 per 100,000 $2,857,283 per year In Total 8,219 per 100,000 A&E attendance rates Notable injury types Need improvement Sports Improving Indecent assault Deteriorating Traffic Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

44 Childhood Injury Profile for Tsuen Wan District
BACK Vulnerable groups 5,933 per 100,000 A&E medical cost 4,614 per 100,000 Girls 0-4 years $150,897 per year (10.9%) Avoidable 4,078 per 100,000 $1,383,200 per year In Total 3,892 per 100,000 A&E attendance rates Notable injury types Need improvement Industrial Improving Domestic Deteriorating Child abuse Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

45 Childhood Injury Profile for Tuen Mun District
BACK Vulnerable groups 8,430 per 100,000 A&E medical cost 6,440 per 100,000 Girls 0-4 years $1,264,317 per year (35.7%) Avoidable 6,074 per 100,000 $3,542,408 per year In Total 5,679 per 100,000 A&E attendance rates Notable injury types Need improvement Child abuse Improving Sports Deteriorating Self-harm Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

46 Childhood Injury Profile for Wan Chai District
BACK Vulnerable groups 6,772 per 100,000 A&E medical cost 5,994 per 100,000 Boys 0-4 years $301,351 per year (37.3%) Avoidable 5,695 per 100,000 $807,100 per year In Total 5,448 per 100,000 A&E attendance rates Notable injury types Need improvement Traffic Improving Domestic Deteriorating Indecent assault Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

47 Childhood Injury Profile for Wong Tai Sin District
BACK Vulnerable groups 6,959 per 100,000 A&E medical cost 5,031 per 100,000 Girls 0-4 years $418,493 per year (19.5%) Avoidable 4,694 per 100,000 $2,151,450 per year In Total 4,637 per 100,000 A&E attendance rates Notable injury types Need improvement Common assault Improving Indecent assault Deteriorating Child abuse Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

48 Childhood Injury Profile for Yau Tsim Mong District
BACK Vulnerable groups 6,588 per 100,000 A&E medical cost 5,149 per 100,000 Girls 0-4 years $320,878 per year (22.8%) Avoidable 4,972 per 100,000 $1,404,783 per year In Total 4,624 per 100,000 A&E attendance rates Notable injury types Need improvement Self-harm Improving Traffic Deteriorating Industrial Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

49 Childhood Injury Profile for Yuen Long District
BACK Vulnerable groups 7,975 per 100,000 A&E medical cost 6,274 per 100,000 Girls 0-4 years $1,165,575 per year (29.1%) Avoidable 5,256 per 100,000 $3,999,392 per year In Total 5,140 per 100,000 A&E attendance rates Notable injury types Need improvement Child abuse Deteriorating Indecent assault Department of Paediatrics & Adolescent Medicine Li Ka Shing Faculty of Medicine, HKU

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