Can Child Deaths Be Prevented? The Arizona Child Fatality Review Program Experience

摘要: Objective. To determine the causes and preventability of child deaths; to assess accuracy death certificate information; number abuse deaths that are misdiagnosed as attributable natural or accidental causes. Methods. Analysis children Results. From 1995–1999, local multidisciplinary fatality review teams (CFRTs) have reviewed 95% all Most medical conditions occurred in first year life. Prematurity was most common condition (1036 deaths) followed by congenital anomalies (662 infectious diseases (470 deaths). Some reasons why CFRTs believed a preventable included inadequate emergency services, poor continuity care, delay seeking care because lack health insurance. There were 4 resulting from infections vaccine-preventable. 263 sudden infant syndrome. Only 38 these infants found lying on their back; 35 side. The rate syndrome decreased 1.1 per 1000 317 Arizona died gun shot wounds. homicides (175) suicides (109). All suicide >9 years old, 77% >14 old. typical victim male (83%) used (70%) kill himself. After CFRTs, it determined 5 67 certificate. In 3 cases, persistent vegetative state many after episode abuse. Although inaction inappropriate action Child Protective Services (CPS) is often thought be cause deaths, ACFRP 79% there had been no previous CPS involvement with child’s family. 61% considered preventable, much responsibility for preventing rests community members (eg, relatives, neighbors) who aware but failed report family CPS. received training proper completion certificates, reported incorrect 13% certificates 16 disagreed examiner manner natural, accidental, undetermined). Because access additional information may not available physician completes certificate, able more accurately than completed Conclusions. Arizona’s above national average (82.16/100 000), could prevented using known prevention strategies safety restraints, pool fencing). mortality data based cannot preventability. states programs suspected