Healthcare Utilization Patterns Among Children With a History of Child Protective Services Investigations

Area of Science:

• Pediatric Health Services Research
• Child Welfare and Healthcare Disparities
• Public Health Policy

Background:

• Child protective services (CPS) investigations are a critical intervention point in child welfare.
• Understanding the downstream healthcare utilization of children with CPS involvement is essential for targeted support.
• Previous research has not fully elucidated the association between CPS history and specific healthcare access metrics.

Purpose of the Study:

• To investigate the association between prior child protective services (CPS) investigations and healthcare utilization in children.
• To compare healthcare access for children with and without a history of CPS involvement.
• To identify potential disparities in medical care receipt and emergency service use.

Main Methods:

• Utilized data from the 2015 Children's Health Assessment and Planning Survey in North Texas.
• Assessed 6,492 primary caregivers of children aged 0-17 years.
• Collected caregiver-reported data on prior CPS investigations and child healthcare utilization, including emergency department (ED) visits, unmet medication needs, and unmet medical care needs.

Main Results:

• A total of 408 (5%) children had a reported CPS investigation.
• Children with a CPS investigation showed significantly higher odds of ED visits (OR = 1.9; 95% CI: 1.4, 2.5).
• Children with a CPS investigation also had greater odds of not receiving necessary medical care (OR = 1.9; 95% CI: 1.4, 2.8).

Conclusions:

• Prior CPS investigations are significantly associated with increased emergency department utilization among children.
• Children with a history of CPS involvement face disparities in receiving necessary medical care.
• Findings underscore the need for integrated healthcare and child welfare services to address access gaps.