Cohort analysis of child abuse and neglect cases treated during the initial 2 years of a programme to support hospital-based child protection work in Austria

Eva Anna Mora-Theuer; Sophie Klomfar; Dariga Ramazanova; Chryssa Grylli; Maria Kletecka-Pulker; Sabine Völkl-Kernstock; Gabriel Otterman; Judit Simon; Susanne Greber-Platzer

doi:10.1136/bmjopen-2022-071536

Cohort analysis of child abuse and neglect cases treated during the initial 2 years of a programme to support hospital-based child protection work in Austria

BMJ Open. 2023 Jul 14;13(7):e071536. doi: 10.1136/bmjopen-2022-071536.

Authors

Eva Anna Mora-Theuer¹, Sophie Klomfar¹, Dariga Ramazanova², Chryssa Grylli¹, Maria Kletecka-Pulker³, Sabine Völkl-Kernstock⁴, Gabriel Otterman^{5

6}, Judit Simon⁷, Susanne Greber-Platzer⁸

Affiliations

¹ Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria.
² Center for Medical Data Science, Medical University of Vienna, Vienna, Austria.
³ Ludwig Boltzmann Institute for Digital Health and Patient Safety, Medical University of Vienna, Vienna, Austria.
⁴ Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.
⁵ Department of Biomedical and Clinical Sciences, Linköping University, Linkoping, Sweden.
⁶ Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
⁷ Department of Health Economics, Center for Public Health, Medical University of Vienna, Vienna, Austria.
⁸ Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria susanne.greber-platzer@meduniwien.ac.at.

Abstract

Objective: To describe characteristics of suspected child abuse and neglect (CAN) cases associated with the decision of paediatric departments (PDs) in Vienna, Austria, to involve services of a regional tertiary child protection service programme (Forensische Kinder- und JugendUntersuchungsStelle, FOKUS).

Design: Retrospective cohort analysis of a regional data collection of CAN cases over the first 2 years of FOKUS's operational period (1 July 2015-30 June 2017).

Setting: All CAN cases reported to the PDs of six public hospitals in Vienna. Five of these public hospitals were secondary heath care centres and one was a tertiary healthcare centre.

Results: Overall, 231 cases (59.1%) were treated without and 160 (40.9%) with additional involvement of the FOKUS service programme. The odds of a case to be treated without FOKUS involvement were higher if neglect was suspected (OR 3.233, 95% CI 2.024 to 5.279). In contrast, when sexual abuse was suspected, the odds for involvement with FOKUS were significantly higher (OR 7.577, 95% CI 4.580 to 12.879). The odds of being managed with FOKUS services nearly doubled when multiple forms of abuse were suspected (OR 1.926, 95% CI 1.136 to 3.285). The odds for additional FOKUS involvement were significantly lower for patients treated as inpatients (OR 0.239, 95% CI 0.151 to 0.373). CAN patients managed with FOKUS involvement were significantly more often reported to law enforcement (LE) (OR 3.234, 95% CI 2.078 to 5.002). Concurrently, suspected sexual abuse cases and cases reported to LE were more frequently treated in the PD of the tertiary centre than in other PDs (χ² p<0.001).

Conclusion: CAN case characteristics significantly influenced if PDs involved a tertiary child protection programme. Suspected sexual abuse, if more than one form of CAN was suspected and cases reported to LE required additional specialist expertise. For suspected neglect involvement of tertiary services seemed less important.

Keywords: child protection; community child health; non-accidental injury; paediatric A&E and ambulatory care.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Austria / epidemiology
Child
Child Abuse* / diagnosis
Child Abuse* / prevention & control
Child Abuse, Sexual* / prevention & control
Cohort Studies
Hospitals, Public
Humans
Retrospective Studies