Send to

Choose Destination
Child Abuse Negl. 2014 Jan;38(1):11-24. doi: 10.1016/j.chiabu.2013.06.011. Epub 2013 Aug 12.

Predicting the decisions of hospital based child protection teams to report to child protective services, police and community welfare services.

Author information

Bar Ilan University, Israel.
The Edmond and Lily Safra Children's Hospital, The Chaim Sheba Medical Center, Israel.
Women & Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research (Ltd), Israel.
Protective Services, Ministry of Welfare and Social Services, Israel.
Gertner Institute for Epidemiology & Health Policy Research (Ltd), USA; UVA Law School, USA; Kiryat Ono College, Israel.
Ministry of Health, Israel.
Women & Children's Health Research Unit, Gertner Institute for Epidemiology & Health Policy Research (Ltd), Israel; The Sackler Faculty of Medicine, Tel Aviv University, Israel.


This study examines judgments made by hospital-based child protection teams (CPTs) when determining if there is reasonable suspicion that a child has been maltreated, and whether to report the case to a community welfare agency, to child protective services (CPS) and/or to the police. A prospective multi-center study of all 968 consecutive cases referred to CPTs during 2010-2011 in six medical centers in Israel. Centers were purposefully selected to represent the heterogeneity of medical centers in Israel in terms of size, geographical location and population characteristics. A structured questionnaire was designed to capture relevant information and judgments on each child referred to the team. Bivariate associations and multivariate multinomial logistic regressions were conducted to predict whether the decisions would be (a) to close the case, (b) to refer the case to community welfare services, or (c) to report it to CPS and/or the police. Bivariate and multivariate analyses identified a large number of case characteristics associated with higher probability of reporting to CPS/police or of referral to community welfare services. Case characteristics associated with the decisions include socio-demographic (e.g., ethnicity and financial status), parental functioning (e.g., mental health), previous contacts with authorities and hospital, current referral characteristics (e.g., parental referral vs. child referral), physical findings, and suspicious behaviors of child and parent. Most of the findings suggest that decisions of CPTs are based on indices that have strong support in the professional literature. Existing heterogeneity between cases, practitioners and medical centers had an impact on the overall predictability of the decision to report. Attending to collaboration between hospitals and community agencies is suggested to support learning and quality improvement.


Child abuse and neglect; Decision making; Hospitals; Israel; Maltreatment; Protective services

[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center