Health care providers' experience reporting child abuse in the primary care setting

Objectives: To describe (1) primary care providers' experiences identifying and reporting suspected child abuse to child protective services (CPS) and (2) variables affecting providers' reporting behavior. Design and Methods: Health care providers (76 physicians. 8 nurse practitio ners, and 1 physician assistant) in a regional practice-based network compl eted written surveys that collected information about the demographic chara cteristics of each provider and practice; the provider's career experience with child abuse; and the providers previous year's experience identifying and reporting suspected child abuse, including experience with CPS. Results: All providers (N = 85) in 17 participating practices completed the survey. in the preceding 1 year, 48 respondents (56%) indicated that they had treated a child they suspected was abused, for an estimated total of 15 2 abused children. Seven (8%) of 85 providers did not re port a total of 7 children with suspected abuse (5% of all suspected cases). A majority of pr oviders (63%; n = 29) believed that children who were reported had not bene fited from CPS intervention, and 21 (49%) indicated that their experience w ith CPS made them less willing to re port future cases of suspected abuse. Providers who had some formal education in child abuse after residency were 10 limes more likely to report all abuse than were providers who had none. Conclusions: Primary care providers report most, hut not all, cases of susp ected chilli abuse that they identify. Past negative experience with CPS an d perceived lack of benefit to the child were common reasons given by provi ders for not reporting. Education increases the probability that providers will report suspected abuse.