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Detection of child abuse in emergency departments: a multi-centre study
Eveline C F M Louwers1, Ida J Korfage, Marjo J Affourtit
1Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands. e.louwers@erasmusmc.nl
Insights
Emergency departments detected suspected child abuse in 0.2% of pediatric visits. Adherence to child abuse screening guidelines in hospitals increased detection rates, suggesting wider implementation could improve identification of abuse cases.
Area of Science:
- Pediatric Emergency Medicine
- Child Abuse Detection
- Healthcare Quality Improvement
Background:
- Child abuse is a significant public health concern requiring effective detection strategies.
- Emergency departments serve as critical points for identifying potential child abuse cases.
- Variability in screening practices may impact the identification rates of suspected child abuse.
Purpose of the Study:
- To compare the detection rates of suspected child abuse in Dutch emergency departments based on compliance with screening guidelines.
- To evaluate the impact of implementing child abuse screening checklists on detection rates.
Main Methods:
- A retrospective analysis of 24,472 emergency department visits for children aged 18 years or younger across seven Dutch hospitals over six months.
- Hospitals were categorized based on compliance with screening guidelines, defined as checklist completion in at least 10% of visits.
- Data collected included demographics, diagnoses, and completion of a child abuse warning signs checklist.
Main Results:
- Suspected child abuse was identified in 52 children (0.2% of total visits).
- Checklist completion was significantly higher in suspected abuse cases (77%) compared to the overall sample (19%).
- Hospitals complying with screening guidelines demonstrated higher detection rates (0.3%) than non-complying hospitals (0.1%, p<0.001).
Conclusions:
- The overall detection rate of suspected child abuse in emergency departments was low (0.2%).
- Compliance with standardized screening guidelines correlated with increased detection rates of suspected child abuse.
- Widespread implementation of uniform screening guidelines is recommended to potentially enhance the identification of child abuse.
Objective:
This study examines the detection rates of suspected child abuse in the emergency departments of seven Dutch hospitals complying and not complying with screening guidelines for child abuse.
Design:
Data on demographics, diagnosis and suspected child abuse were collected for all children aged ≤18 years who visited the emergency departments over a 6-month period. The completion of a checklist of warning signs of child abuse in at least 10% of the emergency department visits was considered to be compliance with screening guidelines.
Results:
A total of 24 472 visits were analysed, 54% of which took place in an emergency department complying with screening guidelines. Child abuse was suspected in 52 children (0.2%). In 40 (77%) of these 52 cases, a checklist of warning signs had been completed compared with a completion rate of 19% in the total sample. In hospitals complying with screening guidelines for child abuse, the detection rate was higher (0.3%) than in those not complying (0.1%, p<0.001).
Conclusion:
During a 6-month period, emergency department staff suspected child abuse in 0.2% of all children visiting the emergency department of seven Dutch hospitals. The numbers of suspected abuse cases detected were low, but an increase is likely if uniform screening guidelines are widely implemented.
