Background

Despite the high prevalence of child abuse and neglect and its consequences on health, very few studies have evaluated the trajectories of children in placement in France, and there are no cost studies available.

Objective

To estimate the cost of abuse and neglect in children in placement before their 4th birthday in France.

Participants and setting

A cohort of children in placement before their 4th birthday in a single nursery between February 1994 and June 2001 was followed from birth until they left care.

Methods

Child protective services (CPS), health, health and social, and judiciary services utilization was derived from a qualitative analysis of the children's files and valued with their unit costs in 2013 euros from the societal perspective. Total costs and mean annual cost per child followed by CPS were calculated overall, by cost category, and by status at admission to the nursery.

Results

129 children were included. Mean age at first admission was 1.9 years (SD = 1.3). The mean length of follow-up by CPS was 14.3 years (SD = 5.0). Mean annual cost per child was estimated at €53,265 (SD = 42,077), with CPS costs representing 78% of costs. 80% of health care costs were due to psychiatric care. Children with no identified psychosocial risk factors had significantly higher psychiatric care costs and health and social care costs than pre-term children and children with identified psychosocial risk factors.

Conclusion

More research should be carried out to address early and comprehensively the multiple needs of children followed by CPS in the short- and long-term.

中文翻译：

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法国虐待和忽视儿童的代价：四岁前被安置的儿童案例

背景

尽管虐待和忽视儿童及其对健康的影响很高，但很少有研究评估法国儿童安置的轨迹，也没有可用的成本研究。

客观的

估计在法国 4 岁之前安置的儿童遭受虐待和忽视的成本。

参与者和设置

在 1994 年 2 月至 2001 年 6 月期间，一组 4 岁生日前被安置在一个托儿所的儿童从出生到离开护理中心进行跟踪。

方法

儿童保护服务 (CPS)、健康、健康和社会以及司法服务的利用源自对儿童档案的定性分析，并从社会角度以 2013 年欧元的单位成本进行估值。总成本和每名儿童的平均年成本按照 CPS 进行了总体计算，按成本类别和进入托儿所时的状态。

结果

包括 129 名儿童。首次入院时的平均年龄为 1.9 岁（SD = 1.3）。CPS 的平均随访时间为 14.3 年（SD = 5.0）。每个孩子的平均年成本估计为 53,265 欧元（标准差 = 42,077），其中 CPS 成本占成本的 78%。80% 的医疗保健费用来自精神科护理。与早产儿和已确定心理社会风险因素的儿童相比，没有确定的心理社会风险因素的儿童的精神护理费用以及健康和社会护理费用显着更高。

结论

应该进行更多的研究，以早期和全面地解决儿童在短期和长期内接受 CPS 的多重需求。