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Detection of child abuse in emergency departments: a multi-centre study
  1. Eveline C F M Louwers1,2,
  2. Ida J Korfage1,
  3. Marjo J Affourtit2,
  4. Dop J H Scheewe3,
  5. Marjolijn H van de Merwe4,
  6. Francoise A F S R Vooijs-Moulaert5,
  7. Claire M C Woltering6,
  8. Mieke H T M Jongejan7,
  9. Madelon Ruige8,
  10. Henriëtte A Moll2,
  11. Harry J De Koning1
  1. 1Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
  2. 2Department of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
  3. 3Department of Pediatrics, IJsselland Hospital, Capelle aan den IJssel, The Netherlands
  4. 4Advies en Meldpunt Kindermishandeling Zuid-Holland, Gouda, The Netherlands
  5. 5Department of Pediatrics, Rivas Zorggroep Beatrix Hospital, Gorinchem, The Netherlands
  6. 6Department of Pediatrics, Reinier de Graaf Gasthuis, Delft, The Netherlands
  7. 7Department of Pediatrics, St Franciscus Gasthuis, Rotterdam, The Netherlands
  8. 8Department of Pediatrics, HagaZiekenhuis Juliana Children's Hospital, The Hague, The Netherlands
  1. Correspondence to Eveline C F M Louwers, Department of Public Health, Erasmus MC, University Medical Centre Rotterdam, Room-Ae 106, PO Box 2040, 3000 CA Rotterdam, The Netherlands; e.louwers{at}erasmusmc.nl

Abstract

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.

This paper is freely available online under the BMJ Journals unlocked scheme, see http://adc.bmj.com/info/unlocked.dtl

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Footnotes

  • Funding This study was funded by the Netherlands Institute for Health Research and Development (ZonMw 63 30 00 23). The authors were completely independent of funders in conducting this study and writing this manuscript.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Medical Ethical Committee of Erasmus MC, Rotterdam, The Netherlands.

  • Provenance and peer review Not commissioned; externally peer reviewed.