Hospital Variation in Child Protection Reports of Substance Exposed Infants - 24/04/19
, Joseph A. Mienko, PhD 1, Emily Brown, MD 2, 3, Ali Rowhani-Rahbar, MD, MPH, PhD 3, 4, 5Abstract |
Objective |
To examine whether hospital-level factors contribute to discrepancies in reporting to Child Protective Services (CPS) of infants diagnosed with prenatal substance exposure.
Study design |
We used a linked dataset of birth, hospital, and CPS records using diagnostic codes (International Classification of Diseases, Ninth Revision) to identify infants diagnosed with prenatal substance exposure. Using multilevel models, we examined hospital-level and individual birth-level factors in relation to a report to CPS among those infants prenatally exposed to substances.
Results |
Of the 760 863 infants born in Washington State between 2006 and 2013, 12 308 (1.6%) were diagnosed with prenatal substance exposure. Infants born at hospitals that served larger populations of patients with Medicaid (OR, 1.25; 95% CI, 1.07-1.45) and hospitals with higher occupancy rates (OR, 1.43; 95% CI, 1.15-1.77) were more likely to be reported to CPS. Infants exposed to amphetamines (OR, 2.58; 95% CI, 2.31-2.90) and cocaine (OR, 2.33; 95% CI-1.92, 2.83) were more likely to be reported and infants exposed to cannabis (OR, 0.62; 95% CI-0.55, 0.70) were less likely to be reported to CPS than infants exposed to opioids. Infants with Native American mothers were more likely to be reported to CPS than infants with white mothers (OR, 1.47; 95% CI, 1.27-1.70).
Conclusions |
Hospital-level and individual birth-level factors impact the likelihood of infants prenatally exposed to substances being reported to CPS, providing additional knowledge about which infants are reported to CPS. Targeted education and improved policies are necessary to ensure more standardized approaches to CPS reporting of prenatal substance exposure.
Le texte complet de cet article est disponible en PDF.Keywords : prenatal substance exposure, child welfare, parental substance use, child protection
Abbreviations : BIC, BMA, CPS, ICD-9, NOS
Plan
| Funded by Steve and Connie Ballmer Family Giving, Casey Family Programs, Stuart Foundation, and partial support for this research came from a Eunice Kennedy Shriver National Institute of Child Health and Human Development research infrastructure grant, P2C HD042828, to the Center for Studies in Demography & Ecology at the University of Washington. This publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number TL1 TR002318. The authors declare no conflicts of interest. |
Vol 208
P. 141 - mai 2019 Retour au numéro
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