Children with medical complexity may be at elevated risk of experiencing child maltreatment and child welfare system involvement, though empirical data are limited. This study examined the extent of child welfare system involvement among children with medical complexity and investigated associated health and social factors. A retrospective chart review of children with medical complexity (N = 208) followed at a pediatric hospital-based complex care program in Canada was conducted. Descriptive statistics and odds ratios using logistic regression were computed. Results showed that nearly one-quarter (23.6%) had documented contact with the child welfare system, most commonly for neglect; of those, more than one-third (38.8%) were placed in care. Caregiver reported history of mental health problems (aOR = 3.19, 95%CI = 1.55–6.56), chronic medical conditions (aOR = 2.86, 95%CI = 1.09–7.47), and interpersonal violence or trauma (aOR = 17.58, 95%CI = 5.43–56.98) were associated with increased likelihood of child welfare system involvement, while caregiver married/common-law relationship status (aOR = 0.35, 95%CI = 0.16–0.74) and higher number of medical technology supports (aOR = 0.75, 95%CI = 0.57–0.99) were associated with decreased likelihood. Implications for intervention and prevention of maltreatment in children with high healthcare needs are discussed.

尽管经验数据有限，但具有医疗复杂性的儿童遭受虐待儿童和儿童福利系统参与的风险可能较高。本研究调查了医疗复杂性儿童中儿童福利系统的参与程度，并调查了相关的健康和社会因素。对加拿大一家以儿科医院为基础的复杂护理项目进行的医疗复杂性儿童 (N = 208) 进行了回顾性图表审查。使用逻辑回归计算描述性统计和优势比。结果显示，近四分之一 (23.6%) 的人记录了与儿童福利系统的接触，最常见的是被忽视；其中，超过三分之一（38.8%）的人接受了护理。照顾者报告了心理健康问题的历史（aOR = 3.19, 95%CI = 1.55–6.56），慢性疾病（aOR = 2.86, 95%CI = 1.09-7.47）和人际暴力或创伤（aOR = 17.58, 95%CI = 5.43-56.98）与儿童福利系统参与的可能性增加有关，而照顾者已婚/普通法关系状态 (aOR = 0.35, 95%CI = 0.16–0.74) 和更多的医疗技术支持 (aOR = 0.75, 95%CI = 0.57–0.99) 与可能性降低有关。讨论了对医疗保健需求高的儿童进行干预和预防虐待的意义。74) 和更多的医疗技术支持 (aOR = 0.75, 95%CI = 0.57–0.99) 与可能性降低有关。讨论了对医疗保健需求高的儿童进行干预和预防虐待的意义。74) 和更多的医疗技术支持 (aOR = 0.75, 95%CI = 0.57–0.99) 与可能性降低有关。讨论了对医疗保健需求高的儿童进行干预和预防虐待的意义。