A gap in the data: Defining, identifying, and tracking children with medical complexity in the child welfare system.

Autor: Chung J; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America., Pecora PJ; University of Washington School of Social Work, Seattle, WA, United States of America; Casey Family Programs, Seattle, WA, United States of America., Sinha A; Casey Family Programs, Seattle, WA, United States of America., Prichett L; Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Lin FY; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America; Johns Hopkins University School of Medicine, Baltimore, MD, United States of America., Seltzer RR; Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States of America; Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Berman Institute of Bioethics, Baltimore, MD, United States of America. Electronic address: rseltze2@jhmi.edu.
Jazyk: angličtina
Zdroj: Child abuse & neglect [Child Abuse Negl] 2024 Jan; Vol. 147, pp. 106600. Date of Electronic Publication: 2023 Dec 20.
DOI: 10.1016/j.chiabu.2023.106600
Abstrakt: Background: Among nearly 400,000 children in US foster care, an estimated 10 % are medically complex. Yet, population-level data about children with medical complexity (CMC) served by the child welfare system, both for prevention and foster care services, are largely unavailable.
Objective: To understand how US child welfare agencies define, identify, and track CMC.
Participants and Setting: Child welfare agencies across the US.
Methods: Agencies were recruited to complete a survey as part of a larger study exploring how CMC are served by the child welfare system. Survey responses related to defining, identifying, and tracking CMC were included in analysis. Descriptive statistical analysis was conducted with Stata. Qualitative content and thematic analysis were applied to free text responses.
Results: Surveys were completed by agencies from 28 states and 2 major cities. Nearly half of the agencies did not have a clear definition to identify CMC; those that did have a definition often lacked standardization. The majority of agencies could not easily identify CMC or access CMC-related data within data systems. Agencies described lack of a clear definition as a barrier to collecting population level data.
Conclusions: Many US child welfare agencies lack a clear definition to identify and track CMC, impacting the ability to tailor care and service delivery to meet their unique needs. To address this, a clear definition for CMC should be developed and consistently applied within child welfare data systems. Once CMC are identifiable, future research can collect population-level data and provide recommendations for best practices and policies.
Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article to disclose.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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