Providing Health Care to Maltreated Children Receiving Child Welfare Services.

Abstract

This study sought associations between maltreated children's receipt of needed health care and five other variables or sets of variables: medical need, social structural factors, access to care, demographic factors, and child welfare intervention. Data for this study came from longitudinal records derived for a sample of 1,465 children (extracted from all records in a national data set) for whom maltreatment had been substantiated. Children in the sample had, following substantiation, either remained in the home or been placed in kinship care or other out-of-home setting. Generalized estimating equations were applied to the data. The results supported a negative association between the sample's receipt of needed health care and three factors: general physical health, age, and remaining in the home after substantiation. Data analysis also supported a positive association between receiving needed care and Medicaid receipt, family income of between 100 percent and 200 percent of federal poverty level, family income above 200 percent of federal poverty level, needed health care services included in child welfare case plan, and wave 2 interview. The study's implications for social work practice include the necessity of accurately identifying children's health problems, of addressing health needs in the case plan, and of coordinating meaningfully with health professionals.