Background

There is significant variability in Child Protective Services (CPS) utilization of medical-forensic experts. In 2016, Missouri legislation (HB 1877) mandated that CPS investigators submit screening forms to a Child Abuse Pediatrician (CAP) to review children < 4 years investigated for abuse. Compliance with this mandate is unknown.

Objective

To measure compliance with HB 1877, hypothesizing that urban counties would have better compliance than rural counties.

Participants and setting

This retrospective study included evaluation of screening forms completed by Missouri CPS and submitted to Missouri CAPs during February, July and September of 2017.

Methods

Compliance was measured in three ways. Compliance Measure 1 (CM1) was the number of screening forms versus the number of eligible CPS investigations. Compliance Measure 2 (CM2) was the average number of days from an abuse report until form submission, and Compliance Measure 3 (CM3) was the percentage of forms with complete information. Urban and rural counties were classified by 2010 census data. t-Tests were used to compare compliance measures between urban and rural counties.

Results

Overall compliance with CM1 was 69% with 1496 screening forms submitted and 2170 child maltreatment investigations for children less than 4 years of age. For CM2, mean days from abuse report to form submission was 30 days. For CM3, 60.5% of statewide forms were complete. There was no significant difference between rural and urban county compliance.

Conclusions

Limited compliance with HB 1877 demonstrates the necessity of continued monitoring and improvement for optimal efficacy of legal mandates.

中文翻译：

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评估 CPS 是否符合法律要求的 CAP 对调查的审查

背景

儿童保护服务 (CPS) 对医学法医专家的利用存在显着差异。2016 年，密苏里州立法 (HB 1877) 要求 CPS 调查员向虐待儿童的儿科医生 (CAP) 提交筛查表，以审查接受虐待调查的 4 岁以下儿童。是否遵守这项任务是未知的。

客观的

为了衡量对 HB 1877 的遵从性，假设城市县比农村县具有更好的遵从性。

参与者和设置

这项回顾性研究包括评估由密苏里州 CPS 完成并在 2017 年 2 月、7 月和 9 月提交给密苏里州 CAP 的筛查表。

方法

依从性以三种方式衡量。合规措施 1 (CM1) 是筛选表格的数量与合格 CPS 调查的数量。合规措施 2 (CM2) 是从滥用报告到提交表格的平均天数，合规措施 3 (CM3) 是具有完整信息的表格的百分比。城乡县按2010年人口普查数据分类。t检验用于比较城乡县之间的合规措施。

结果

CM1 的总体依从率为 69%，提交了 1496 份筛查表，对 4 岁以下儿童进行了 2170 份虐待儿童调查。对于 CM2，从滥用报告到提交表单的平均天数为 30 天。对于 CM3，全州 60.5% 的表格是完整的。农村和城市县依从性没有显着差异。

结论

对 HB 1877 的有限遵守表明有必要继续监测和改进以实现法律授权的最佳效力。