Participants

Our study cohort was identified from the research database (Fig 1). “Exposed children” were defined as Medicaid-enrolled children aged 0 to 14 years with a first-time CPS finding of maltreatment between January 2007 and December 2009 not resulting in out-of-home (foster) placement. From the 18 713 children with a first-time finding of maltreatment, 11 299 (60.4%) were not enrolled in Medicaid during the month of this first CPS finding. Of the remaining children, 821 (11.1%) were excluded due to foster care placement in the month after the first CPS finding. The remaining 6593 children defined the exposed children for this analysis. “Unexposed children” were defined as children 0 to 14 years of age enrolled in Medicaid at any time between January 2007 and December 2009 who had no history of CPS involvement. The 52 661 children selected at random from the Medicaid database were back-matched to the DCFS database. Of these, 13 480 (25.6%) had a history of CPS involvement between 1993 and 2013, leaving 39 181 unexposed children for the present analysis.