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Updated: Nov 23, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Reports and Removals of Child Maltreatment-Related Hospitalizations: A Population-Based Study
Rebecca Rebbe1, Joseph A Mienko2, Melissa L Martinson3
1Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
Insights
Mandated reporters do not refer all child maltreatment hospitalizations to child protective services (CPS). Two-thirds of these children were not reported, though abuse-related hospitalizations increased reporting and removal odds.
Area of Science:
- Pediatrics
- Public Health
- Social Work
Background:
- Child protective services (CPS) agencies depend on mandated reporters for maltreatment referrals.
- Limited data exists on which children are reported and not reported by mandated reporters.
- Understanding reporting disparities is crucial for child welfare.
Purpose of the Study:
- To identify which hospitalized children with maltreatment-related reasons are reported to CPS.
- To determine which of these children are subsequently removed by CPS.
- To analyze factors influencing CPS reporting and removal decisions.
Main Methods:
- Utilized a population-based linked administrative dataset in Washington State (1999-2013).
- Included all births, hospitalizations for children under three, and CPS records.
- Identified maltreatment-related hospitalizations using diagnostic codes and analyzed CPS reports and removals via multinomial regression.
Main Results:
- Approximately two-thirds of children with maltreatment-related hospitalizations were not reported to CPS.
- Significant differences in CPS response were observed based on maltreatment subtype and diagnostic codes.
- Hospitalizations for abuse linked to specific codes showed higher odds of CPS reporting and child removal.
Conclusions:
- Current reporting practices by mandated reporters may miss a significant number of child maltreatment cases.
- Specific maltreatment types and associated diagnostic codes influence CPS intervention.
- Further research is needed to ensure equitable and effective child protection system responses.
Abstract:
Despite U.S. child protective services (CPS) agencies relying on mandated reporters to refer concerns of child maltreatment to them, there is little data regarding which children mandated reporters decide to report and not to report. This study addresses this gap by utilizing a population-based linked administrative dataset to identify which children who are hospitalized for maltreatment-related reasons are reported to CPS and which are removed by CPS. The dataset was comprised of all children born in Washington State between 1999 and 2013 (N = 1,271,416), all hospitalizations for children under the age of three, and all CPS records. We identified maltreatment-related hospitalizations using standardized diagnostic codes. We examined the records for children with maltreatment-related hospitalizations to identify hospitalization-related CPS reports and if the child was removed from their parents. We tested for differences in these system responses using multinomial regression. About two-thirds of children identified as experiencing a child maltreatment-related hospitalization were not reported to CPS. We found differences in responses by maltreatment subtype and the type of diagnostic code. Children whose hospitalizations were related to abuse and associated with a specific maltreatment code had increased odds of being both reported to CPS and subsequently removed by CPS.
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