• Daniel M Lindberg, Ryan A Peterson, Rebecca Orsi-Hunt, Pang Ching Bobby Chen, Briana Kille, Jacob G Rademacher, Colin Hensen, David Listman, and Toan C Ong.
• Department of Emergency Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO; The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, University of Colorado Anschutz Medical Campus, Aurora, CO. Electronic address: daniel.lindberg@ucdenver.edu.
• Ann Emerg Med. 2024 Jun 18.

Study ObjectiveEmergency department (ED) screening for child physical abuse has been widely implemented, with uncertain effects on child abuse identification. Our goal was to determine the effect of screening on referrals to child protective services (CPS) identifying abuse.MethodsWe performed a retrospective cohort study of children younger than 6 years old with an ED encounter at 1 of 2 large health care systems, one of which implemented routine child abuse screening. The main outcome was initial (<2 days) or subsequent (3 to 180 days) referral to CPS identifying child abuse using linked records. We compared outcomes for the 2-year period after screening was implemented to the preperiod and nonscreening EDs using generalized estimating equations to adjust for sex, age, race/ethnicity, payor and prior ED encounters and clustered by center.ResultsOf the 331,120 ED encounters, 41,589 (12.6%) occurred at screening EDs during the screening period. Screening was completed in 34,272 (82%) and was positive in 188 (0.45%). Overall, 7,623 encounters (2.3%) had a subsequent referral, of which 589 (0.2%) identified moderate or severe abuse. ED screening did not change initial (adjusted odds ratio [aOR]=1.01, 95% confidence interval [CI] 0.89 to 1.15) or subsequent referral to CPS when compared to the prescreening period (aOR=1.05, 95% CI 0.9 to 1.18) or to the nonscreening EDs (aOR=1.06, 95% CI 0.92 to 1.21).ConclusionRoutine screening did not affect initial or subsequent referrals to CPS.Copyright © 2024 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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