The cost of child abuse and neglect in France: The case of children in placement before their fourth birthday.

Child abuse and neglect Child protective services Cost analysis Economic burden

Journal

Child abuse & neglect
ISSN: 1873-7757
Titre abrégé: Child Abuse Negl
Pays: England
ID NLM: 7801702

Informations de publication

Date de publication:
08 2021
Historique:
received: 28 12 2020
revised: 06 05 2021
accepted: 17 05 2021
pubmed: 1 6 2021
medline: 11 1 2022
entrez: 31 5 2021
Statut: ppublish

Résumé

Despite the high prevalence of child abuse and neglect and its consequences on health, very few studies have evaluated the trajectories of children in placement in France, and there are no cost studies available. To estimate the cost of abuse and neglect in children in placement before their 4th birthday in France. A cohort of children in placement before their 4th birthday in a single nursery between February 1994 and June 2001 was followed from birth until they left care. Child protective services (CPS), health, health and social, and judiciary services utilization was derived from a qualitative analysis of the children's files and valued with their unit costs in 2013 euros from the societal perspective. Total costs and mean annual cost per child followed by CPS were calculated overall, by cost category, and by status at admission to the nursery. 129 children were included. Mean age at first admission was 1.9 years (SD = 1.3). The mean length of follow-up by CPS was 14.3 years (SD = 5.0). Mean annual cost per child was estimated at €53,265 (SD = 42,077), with CPS costs representing 78% of costs. 80% of health care costs were due to psychiatric care. Children with no identified psychosocial risk factors had significantly higher psychiatric care costs and health and social care costs than pre-term children and children with identified psychosocial risk factors. More research should be carried out to address early and comprehensively the multiple needs of children followed by CPS in the short- and long-term.

Sections du résumé

BACKGROUND
Despite the high prevalence of child abuse and neglect and its consequences on health, very few studies have evaluated the trajectories of children in placement in France, and there are no cost studies available.
OBJECTIVE
To estimate the cost of abuse and neglect in children in placement before their 4th birthday in France.
PARTICIPANTS AND SETTING
A cohort of children in placement before their 4th birthday in a single nursery between February 1994 and June 2001 was followed from birth until they left care.
METHODS
Child protective services (CPS), health, health and social, and judiciary services utilization was derived from a qualitative analysis of the children's files and valued with their unit costs in 2013 euros from the societal perspective. Total costs and mean annual cost per child followed by CPS were calculated overall, by cost category, and by status at admission to the nursery.
RESULTS
129 children were included. Mean age at first admission was 1.9 years (SD = 1.3). The mean length of follow-up by CPS was 14.3 years (SD = 5.0). Mean annual cost per child was estimated at €53,265 (SD = 42,077), with CPS costs representing 78% of costs. 80% of health care costs were due to psychiatric care. Children with no identified psychosocial risk factors had significantly higher psychiatric care costs and health and social care costs than pre-term children and children with identified psychosocial risk factors.
CONCLUSION
More research should be carried out to address early and comprehensively the multiple needs of children followed by CPS in the short- and long-term.

Identifiants

pubmed: 34058479
pii: S0145-2134(21)00202-7
doi: 10.1016/j.chiabu.2021.105129
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105129

Informations de copyright

Copyright © 2021 Elsevier Ltd. All rights reserved.

Auteurs

Amélie Prigent (A)

Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, Paris, France; INSERM, ECEVE UMR 1123, Paris, France; Université de Paris, ECEVE, Paris, France.

Marie-Amélie Vinet (MA)

Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, Paris, France; INSERM, ECEVE UMR 1123, Paris, France; Université de Paris, ECEVE, Paris, France.

Morgane Michel (M)

Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, Paris, France; INSERM, ECEVE UMR 1123, Paris, France; Université de Paris, ECEVE, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, Paris, France. Electronic address: morgane.michel@aphp.fr.

Mireille Rozé (M)

CHU Angers, 4 Rue Larrey, 49100 Angers, France.

Elise Riquin (E)

CHU Angers, 4 Rue Larrey, 49100 Angers, France.

Philippe Duverger (P)

CHU Angers, 4 Rue Larrey, 49100 Angers, France.

Daniel Rousseau (D)

CHU Angers, 4 Rue Larrey, 49100 Angers, France.

Karine Chevreul (K)

Assistance Publique-Hôpitaux de Paris, DRCI, URC Eco Ile-de-France, Paris, France; INSERM, ECEVE UMR 1123, Paris, France; Université de Paris, ECEVE, Paris, France; Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Unité d'épidémiologie clinique, Paris, France.

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Classifications MeSH