Healthcare utilisation among children in contact with social services in England: An interrupted time series using ECHILD

IF 3.4 2区心理学 Q1 FAMILY STUDIES

Child Abuse & Neglect Pub Date : 2026-03-01 Epub Date: 2026-02-03 DOI:10.1016/j.chiabu.2026.107916

Eliazar Luna , Lucy J. Griffiths , Karen Broadhurst OBE , Dougal Hargreaves , Jenny Woodman , Lisa Holmes , Kat Tranter , Grace A. Bailey , Katie Harron

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引用次数: 0

Abstract

Background

Children in contact with children's social care (CSC) services have high levels of hospital utilisation, but patterns before and after referral remain insufficiently understood.

Objective

To evaluate healthcare utilisation two years before and after CSC referral.

Participants and setting

Retrospective cohort using ECHILD linked health and social care data, including children with a first CSC referral between 2009 and 2018 in England.

Methods

We compared monthly planned and unplanned hospital contact rates for Children in Need, Children under Protection Plans, and Children Looked After with age-sex-matched cohorts. We used interrupted time series analysis to examine how healthcare utilisation changed following referral. We also explored reasons for hospital contacts.

Results

We analysed >12 million hospital contacts for 1,014,330 Children in Need, 204,240 Children under Protection Plan and 177,640 Children Looked After. Children Looked After had the highest average number of total contacts (11.8 per child over a 4 year period), followed by Children in Need (8.8) and Children under Protection Plans (8.4). All CSC groups had about twice the contacts of matched peers. Healthcare utilisation increased sharply prior to referral, with a peak around referral. After referral, planned care increased and unplanned care decreased, with pre referral upward trends slowing or reversing. The most common reason for healthcare utilisation was mental health–related.

Conclusions

At a population level, CSC referral marks a pivotal point in healthcare utilisation, with a shift from unplanned to planned care. This may reflect more structured engagement with health services and coordinated support for children and families.

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英格兰与社会服务机构接触的儿童的医疗保健利用：使用ECHILD的中断时间序列。

背景：接触儿童社会护理（CSC）服务的儿童有很高的医院使用率，但转诊前后的模式仍不充分了解。目的：评价CSC转诊前后两年的医疗保健利用情况。参与者和环境：使用与ECHILD相关的健康和社会护理数据的回顾性队列，包括2009年至2018年在英国首次转诊的儿童。方法：我们比较有需要的儿童、受保护计划的儿童和受照顾的儿童每月计划和计划外的医院接触率，并与年龄性别匹配的队列进行比较。我们使用中断时间序列分析来检查转诊后医疗保健利用率的变化情况。我们还探讨了医院接触的原因。结果：我们分析了1014,330名有需要的儿童、204,240名受保护计划的儿童和177,640名受到照顾的儿童的bb1,200万医院联系人。受照顾儿童的平均总接触次数最高（4年期间每个儿童11.8次），其次是需要帮助的儿童（8.8次）和受保护计划的儿童（8.4次）。所有CSC组的接触人数大约是匹配组的两倍。在转诊之前，医疗保健利用率急剧增加，在转诊前后达到峰值。转诊后，计划照护增加，计划外照护减少，转诊前的上升趋势减慢或逆转。利用医疗保健的最常见原因是与心理健康有关。结论：在人口水平上，CSC转诊标志着医疗保健利用的关键点，从计划外护理到计划内护理的转变。这可能反映了对保健服务的更有组织的参与和对儿童和家庭的协调支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child Abuse & Neglect Multiple-

CiteScore

7.40

自引率

10.40%

发文量

397

期刊介绍： Official Publication of the International Society for Prevention of Child Abuse and Neglect. Child Abuse & Neglect The International Journal, provides an international, multidisciplinary forum on all aspects of child abuse and neglect, with special emphasis on prevention and treatment; the scope extends further to all those aspects of life which either favor or hinder child development. While contributions will primarily be from the fields of psychology, psychiatry, social work, medicine, nursing, law enforcement, legislature, education, and anthropology, the Journal encourages the concerned lay individual and child-oriented advocate organizations to contribute.