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Soc. Sci. 2014, 3(4), 771-784; doi:10.3390/socsci3040771

Addressing the Clinical Burden of Child Physical Abuse and Neglect in a Large Metropolitan Region: Improving the Evidence-Base

1
Western Clinical School, University of New South Wales, Liverpool Hospital, Liverpool, NSW 2170, Australia
2
Child Protection, Sydney Local Health District, Croydon Health Centre, 24 Liverpool Road, Croydon, NSW 2132, Australia
3
Child, Youth, Women and Families Health, South Eastern Sydney Local Health District, GPO Box 1614, Sydney, NSW 2001, Australia
4
Australian Institute of Health Innovation, University of New South Wales, Sydney, NSW 2052, Australia
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Received: 23 July 2014 / Revised: 8 October 2014 / Accepted: 8 October 2014 / Published: 20 October 2014
(This article belongs to the Special Issue Contemporary Developments in Child Protection)
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Abstract

Children at risk of abuse are more likely to be hospitalized and utilize health services according to international research. In a large metropolitan health region in New South Wales, Australia, there was little known of the clinical burden of child physical abuse and/or neglect (PAN), or of systems for clinical assessment of children presenting with abuse/neglect. We aimed to identify the number of children presenting with suspected PAN to emergency departments (EDs) and paediatric services in this region, to determine enablers and barriers to assessment for children with PAN presenting to frontline services, and to identify best practices to address gaps. We collated available data on children presenting to EDs and paediatric services with suspected PAN in 2007. We interviewed 36 health professionals from nine hospitals and 12 statutory child protection professionals, across the region before undertaking relevant document analysis. Of 64,700 paediatric ED presentations, a quarter were due to injury; 2%–5% of these were due to maltreatment. Clinician estimates and assessments of PAN varied widely; health and welfare workers identified major practice gaps, as well as good local practice. We identified feasible minimum standards for improving clinical assessment and follow-up for children presenting with PAN, given the right organizational support. View Full-Text
Keywords: child abuse and neglect; child maltreatment; quality improvement; audit; health services; emergency health services; child welfare; systems improvement child abuse and neglect; child maltreatment; quality improvement; audit; health services; emergency health services; child welfare; systems improvement
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Raman, S.; Maiese, M.; Hurley, K.; Greenfield, D. Addressing the Clinical Burden of Child Physical Abuse and Neglect in a Large Metropolitan Region: Improving the Evidence-Base. Soc. Sci. 2014, 3, 771-784.

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