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Abstract：
To describe characteristics of suspected child abuse and neglect (CAN) cases associated with the decision of paediatric departments (PDs) in Vienna, Austria, to involve services of a regional tertiary child protection service programme (Forensische Kinder- und JugendUntersuchungsStelle, FOKUS).
Retrospective cohort analysis of a regional data collection of CAN cases over the first 2 years of FOKUS\'s operational period (1 July 2015-30 June 2017).
All CAN cases reported to the PDs of six public hospitals in Vienna. Five of these public hospitals were secondary heath care centres and one was a tertiary healthcare centre.
Overall, 231 cases (59.1%) were treated without and 160 (40.9%) with additional involvement of the FOKUS service programme. The odds of a case to be treated without FOKUS involvement were higher if neglect was suspected (OR 3.233, 95% CI 2.024 to 5.279). In contrast, when sexual abuse was suspected, the odds for involvement with FOKUS were significantly higher (OR 7.577, 95% CI 4.580 to 12.879). The odds of being managed with FOKUS services nearly doubled when multiple forms of abuse were suspected (OR 1.926, 95% CI 1.136 to 3.285). The odds for additional FOKUS involvement were significantly lower for patients treated as inpatients (OR 0.239, 95% CI 0.151 to 0.373). CAN patients managed with FOKUS involvement were significantly more often reported to law enforcement (LE) (OR 3.234, 95% CI 2.078 to 5.002). Concurrently, suspected sexual abuse cases and cases reported to LE were more frequently treated in the PD of the tertiary centre than in other PDs (χ2 p<0.001).
CAN case characteristics significantly influenced if PDs involved a tertiary child protection programme. Suspected sexual abuse, if more than one form of CAN was suspected and cases reported to LE required additional specialist expertise. For suspected neglect involvement of tertiary services seemed less important.
Retrospective cohort analysis of a regional data collection of CAN cases over the first 2 years of FOKUS\'s operational period (1 July 2015-30 June 2017).
All CAN cases reported to the PDs of six public hospitals in Vienna. Five of these public hospitals were secondary heath care centres and one was a tertiary healthcare centre.
Overall, 231 cases (59.1%) were treated without and 160 (40.9%) with additional involvement of the FOKUS service programme. The odds of a case to be treated without FOKUS involvement were higher if neglect was suspected (OR 3.233, 95% CI 2.024 to 5.279). In contrast, when sexual abuse was suspected, the odds for involvement with FOKUS were significantly higher (OR 7.577, 95% CI 4.580 to 12.879). The odds of being managed with FOKUS services nearly doubled when multiple forms of abuse were suspected (OR 1.926, 95% CI 1.136 to 3.285). The odds for additional FOKUS involvement were significantly lower for patients treated as inpatients (OR 0.239, 95% CI 0.151 to 0.373). CAN patients managed with FOKUS involvement were significantly more often reported to law enforcement (LE) (OR 3.234, 95% CI 2.078 to 5.002). Concurrently, suspected sexual abuse cases and cases reported to LE were more frequently treated in the PD of the tertiary centre than in other PDs (χ2 p<0.001).
CAN case characteristics significantly influenced if PDs involved a tertiary child protection programme. Suspected sexual abuse, if more than one form of CAN was suspected and cases reported to LE required additional specialist expertise. For suspected neglect involvement of tertiary services seemed less important.
摘要：
目的：描述与维也纳儿科部门（PDs）决定相关的可疑虐待和忽视儿童（CAN）案件的特征，奥地利,涉及区域三级儿童保护服务方案的服务(ForensischeKinder-undJugendUntersuchungsStelle，FOKUS).
方法：对FOKUS运行期前2年（2015年7月1日至2017年6月30日）的CAN病例区域数据进行回顾性队列分析。
方法：向维也纳六家公立医院报告的所有CAN病例。这些公立医院中有五家是二级保健中心，一家是三级保健中心。
结果：总体而言，231例（59.1％）未接受FOKUS服务计划的治疗和160例（40.9％）的额外参与。如果怀疑忽视，则没有FOKUS参与的病例接受治疗的几率更高（OR3.233，95％CI2.024至5.279）。相比之下,当怀疑性虐待时，参与FOKUS的几率显著较高(OR7.577,95%CI4.580~12.879).当怀疑有多种形式的滥用时，使用FOKUS服务进行管理的几率几乎翻了一番（OR1.926，95％CI1.136至3.285）。作为住院患者治疗的患者增加FOKUS受累的几率显著较低(OR0.239,95%CI0.151至0.373)。接受FOKUS治疗的CAN患者向执法部门（LE）报告的频率明显更高（OR3.234，95％CI2.078至5.002）。同时,在三级中心的PD中,疑似性虐待病例和LE报告的病例的治疗频率高于其他PD(χ2p<0.001).
结论：如果PD涉及三级儿童保护计划，则CAN病例特征受到显著影响。涉嫌性虐待,如果怀疑有一种以上形式的CAN，并且报告给LE的病例需要额外的专业知识。对于可疑的疏忽，三级服务的参与似乎不那么重要。
方法：对FOKUS运行期前2年（2015年7月1日至2017年6月30日）的CAN病例区域数据进行回顾性队列分析。
方法：向维也纳六家公立医院报告的所有CAN病例。这些公立医院中有五家是二级保健中心，一家是三级保健中心。
结果：总体而言，231例（59.1％）未接受FOKUS服务计划的治疗和160例（40.9％）的额外参与。如果怀疑忽视，则没有FOKUS参与的病例接受治疗的几率更高（OR3.233，95％CI2.024至5.279）。相比之下,当怀疑性虐待时，参与FOKUS的几率显著较高(OR7.577,95%CI4.580~12.879).当怀疑有多种形式的滥用时，使用FOKUS服务进行管理的几率几乎翻了一番（OR1.926，95％CI1.136至3.285）。作为住院患者治疗的患者增加FOKUS受累的几率显著较低(OR0.239,95%CI0.151至0.373)。接受FOKUS治疗的CAN患者向执法部门（LE）报告的频率明显更高（OR3.234，95％CI2.078至5.002）。同时,在三级中心的PD中,疑似性虐待病例和LE报告的病例的治疗频率高于其他PD(χ2p<0.001).
结论：如果PD涉及三级儿童保护计划，则CAN病例特征受到显著影响。涉嫌性虐待,如果怀疑有一种以上形式的CAN，并且报告给LE的病例需要额外的专业知识。对于可疑的疏忽，三级服务的参与似乎不那么重要。
