Characteristics of child welfare investigations reported by healthcare professionals in Ontario: secondary analysis of a regional database

OBJECTIVES: This study examines the characteristics and outcomes of child welfare investigations reported by hospital-based and community-based healthcare professionals. METHODS: A sample of 7590 child maltreatment-related investigations from the Ontario Incidence Study of Reported Child Abuse and Neglect-2018, a cross-sectional study, was analysed. Bivariate analyses compared characteristics of hospital and community healthcare-reported investigations. Chi-square automatic interaction detector analyses were used to predict the most influential factors in the decision to provide a family with services following a child welfare investigation from each referral source. RESULTS: Community healthcare-reported investigations were more likely to have a primary concern of physical abuse while hospital-reported investigations were more likely to be focused on assessing risk of future maltreatment. Hospital-reported investigations were more likely to involve noted primary caregiver (eg, mental health issues, alcohol/drug abuse, victim of intimate partner violence (IPV)) and household risk factors. The most significant predictor of service provision following an investigation was having a caregiver who was identified as a victim of IPV in hospital-reported investigations (χ(2)=30.237, df=1, adj. p<0.001) and having a caregiver for whom few social supports was noted in community healthcare-reported investigations (χ(2)=18.892, df=1, adj. p<0.001). CONCLUSION: Healthcare professionals likely interact with children who are at high risk for maltreatment. This study’s findings highlight the important role that healthcare professionals play in child maltreatment identification, which may differ across hospital-based and community-based settings and has implications for future collaborations between the healthcare and child welfare systems.