• Report
  • October 1, 2012

2012 Survey Findings: Children's Hospitals Child Abuse Services

2012 Survey Findings Children's Hospitals Child Abuse Services Cover ImageThe Association supports the commitment of children's hospitals in responding to child maltreatment through a triennial survey of child abuse services at children's hospitals. The objectives:
  • quantify the role of children's hospitals in responding to child maltreatment
  • provide a tool that measures adherence to the Association's guidance for developing and enhancing child protection teams as defined by the 2011 publication Defining the Children's Hospital Role in Child Maltreatment, Second Edition
  • serve as a practical benchmarking resource for child protection teams and hospitals
  • support vulnerable children so that they may better reach their full potential

General Data Findings

Summarized below are significant findings from the 2012 data, a comparison of the 2012 and 2008 data, and observations of how the data compare to recommendations made in Defining the Children's Hospital Role in Child Maltreatment, Second Edition.

Caseload is increasing.
A majority of respondents to the 2012 snapshot report a rise in caseload. The data support that the growth in caseload is due in part to increased referrals from both the hospital and community. This could be due to heightened recognition of subspecialty expertise and specialized services and improved coordination with partners in the community.

The trend data also support the increase in caseload. Measuring the change in caseload from 2008 and 2012 finds a modest increase (9%).

FTE is unchanged.
Although a majority of respondents to the 2012 snapshot report an increase in dedicated FTE since 2008, a comparison of FTE from 2008 and 2012 shows no change in staffing.

Operating expenses are increasing.
On the other hand, comparing data from 2008 and 2012 shows a 10 percent increase in direct operating expenses. This is not surprising given the rise in health care costs nationally.

Child protection teams are not financially self-sustaining in general.
Each survey findings report published by Children’s Hospital Association has evidenced that child protection teams cannot be sustained by relying solely on reimbursement. Health care reimbursement is not going to increase, and moreover, the model for payment is changing as health care expenses escalate.

The 2008 and 2012 surveys show clearly that child protection teams depend on a variety of revenue sources. On average, hospitals cover almost half (47%) of direct expenses of their child protection teams. Moreover, well over half (62%) of respondents say that another organization in addition to the hospital covers some direct or indirect expenses of the child protection team. 

Respondents want to see growth in child abuse pediatrics.
Currently, there are 22 Accreditation Council for Graduate Medical Education accredited fellowships in the country. Almost half of respondents (46 of 93) say that they intend to establish fellowships in the future, and 24 say it would occur in 2015 or earlier. At the least, this shows enthusiasm for growing the ranks of these uniquely qualified providers.

Child protection team training of other health care providers and allied professionals has increased.
Although teams are frequently only partially or not reimbursed for training, the percentage of respondents providing training has grown. More child protection teams are reaching more professionals who are likely to encounter abuse but may not have the knowledge to recognize it.

Child protection teams are more frequently engaged in child abuse prevention activities than others at the hospital.
The opportunity for the hospital and child protection team to partner to prevent child abuse seems to exist, but the disconnect may be illustrated by the finding that over 10 percent of respondents “don’t know” whether others in the hospital are conducting many of the prevention activities listed.

The national emphasis on prevention in general and the latest data that show the lifetime financial costs of child abuse are similar to other costly health conditions such as stroke (Centers for Disease Control and Prevention, 2012), underscore the need for a coordinated approach to prevention.

Thank you to the 145 respondents and hospitals that made this report possible.

Using this Report

The following report is divided into two main sections:
  1. Snapshot of FY 2011 data about child protection teams
  2. A comparison of data from teams that provided both FY 2011 and FY 2007 data
New features of the report include the child protection team profiles in the appendices based on program type, hospital type and pediatric population size. These new tools are intended to enhance the reader’s ability to benchmark.