Routine Emergency Department Screening to Decrease Subsequent Physical Abuse

Daniel M Lindberg; Ryan A Peterson; Rebecca Orsi-Hunt; Pang Ching Bobby Chen; Briana Kille; Jacob G Rademacher; Colin Hensen; David Listman; Toan C Ong

doi:10.1016/j.annemergmed.2024.04.025

Back

Routine Emergency Department Screening to Decrease Subsequent Physical Abuse

Journal article

Peer reviewed

Routine Emergency Department Screening to Decrease Subsequent Physical Abuse

Daniel M Lindberg, Ryan A Peterson, Rebecca Orsi-Hunt, Pang Ching Bobby Chen, Briana Kille, Jacob G Rademacher, Colin Hensen, David Listman and Toan C Ong

Annals of emergency medicine, Vol.84(6), pp.628-638

12/01/2024

DOI: 10.1016/j.annemergmed.2024.04.025

PMID: 38888534

View Online

Abstract

Emergency department (ED) screening for child physical abuse has been widely implemented, with uncertain effects on child abuse identification. Our goal was to determine the effect of screening on referrals to child protective services (CPS) identifying abuse. We performed a retrospective cohort study of children younger than 6 years old with an ED encounter at 1 of 2 large health care systems, one of which implemented routine child abuse screening. The main outcome was initial (<2 days) or subsequent (3 to 180 days) referral to CPS identifying child abuse using linked records. We compared outcomes for the 2-year period after screening was implemented to the preperiod and nonscreening EDs using generalized estimating equations to adjust for sex, age, race/ethnicity, payor and prior ED encounters and clustered by center. Of the 331,120 ED encounters, 41,589 (12.6%) occurred at screening EDs during the screening period. Screening was completed in 34,272 (82%) and was positive in 188 (0.45%). Overall, 7,623 encounters (2.3%) had a subsequent referral, of which 589 (0.2%) identified moderate or severe abuse. ED screening did not change initial (adjusted odds ratio [aOR]=1.01, 95% confidence interval [CI] 0.89 to 1.15) or subsequent referral to CPS when compared to the prescreening period (aOR=1.05, 95% CI 0.9 to 1.18) or to the nonscreening EDs (aOR=1.06, 95% CI 0.92 to 1.21). Routine screening did not affect initial or subsequent referrals to CPS.

Child

Child Abuse - diagnosis

Child Abuse - prevention & control

Child Abuse - statistics & numerical data

Child Protective Services - statistics & numerical data

Child, Preschool

Emergency Service, Hospital - statistics & numerical data

Female

Humans

Infant

Infant, Newborn

Male

Mass Screening - methods

Physical Abuse - statistics & numerical data

Referral and Consultation - statistics & numerical data

Retrospective Studies

Details

Title: Subtitle: Routine Emergency Department Screening to Decrease Subsequent Physical Abuse
Creators: Daniel M Lindberg - University of Colorado Anschutz Medical Campus
Ryan A Peterson - University of Colorado Anschutz Medical Campus
Rebecca Orsi-Hunt - University of Colorado Anschutz Medical Campus
Pang Ching Bobby Chen - Idaho State Department of Education
Briana Kille - University of Colorado Denver
Jacob G Rademacher - University of Colorado Anschutz Medical Campus
Colin Hensen - University of Colorado Anschutz Medical Campus
David Listman - University of Colorado Anschutz Medical Campus
Toan C Ong - University of Colorado Anschutz Medical Campus
Resource Type: Journal article
Publication Details: Annals of emergency medicine, Vol.84(6), pp.628-638
DOI: 10.1016/j.annemergmed.2024.04.025
PMID: 38888534
NLM abbreviation: Ann Emerg Med
ISSN: 0196-0644
eISSN: 1097-6760
Language: English
Date published: 12/01/2024
Academic Unit: Biostatistics; Internal Medicine
Record Identifier: 9984914149502771

Metrics

3 Record Views

See more details