New developments in medical child protection

Abstract

Background and objectives: The current developments in child protection in medicine in Germany are presented with respect to procedures in the healthcare system, advanced training and research as well as quality assurance, financing and objectives. Since 2000 medical child protection has significantly changed and advanced mainly due to the initiative of the German Society for Child Protection in Medicine (DGKiM) and many other contributors. Material and methods: An analysis of the current state of child protection medical care in Germany including the evaluation of a survey on the financing of child protection teams (CPT). Professional policy changes and current child protection projects in the healthcare system are also presented. Results: Since 2008, a child protection medical care network has been established in Germany consisting of 71 CPTs accredited by the DGKiM and 180 child protection physicians certified by the DGKiM. A survey conducted in August 2018 showed that among the 71 involved CPTs, 42 (58%) treated outpatient cases in addition to inpatient cases. Out of a total of 1790 outpatient cases, 527 (29.4%) were treated in 12 months without any financial compensation. In the inpatient sector, a payment (ZE2018-152) based on the German operation and procedure code (OPS) 1‑945 and negotiated by 22 hospitals was between 660 € and 1700 € per case, on average approximately 900 € without a case conference and 1100 € with a case conference involving the Child Protection Service. The new German child protection guidelines published by the Association of the Scientific Medical Societies in Germany (AWMF) in 2019 and the accreditation and certification serve as quality assurance in child protection. Projects initiated by individual states (e.g. Saxony, Thuringia and North Rhine-Westphalia) show how child protection medicine can be set up and maintained across the board. Conclusion: The developments over the last 10 years show the establishment and professionalization of medical child protection in Germany as an interdisciplinary cross-sectional specialty. It has now become an integral part of pediatric specialist training due to the newly introduced changes in training regulations in 2018. Increased integration into teaching, advanced training, research and the establishment of financing models and care structures should lead to long-term and needs-based quality assurance in child protection medicine, significantly and sustainably improving the care of children and adolescents.