Factors associated with re-entry to out-of-home care among children in England

Abstract

Exiting and re-entering out-of-home care (OHC) is considered a disruption to permanence which may have long-lasting, negative consequences for children due to a lack of stability and continuity. Each year approximately one-third of children in OHC in England exit, but information is lacking on rates of re-entries and associated factors. Using national administrative data, we calculated rates of re-entry among children exiting OHC from 2007 to 2012, identified key child and care factors associated with re-entry using Cox proportional hazards modelling, and developed a simple probability calculator to estimate which groups of children are most likely to re-enter OHC within three months. Between 2007 and 2012 reentries to OHC in England decreased (from 23.3% to 14.4% within one year of exit, p < 0.001), possibly due to concurrent changes in the way children exited OHC. Overall, more than one-third of children exiting OHC in 2008 re-entered within five years (35.3%, N = 4076), but rates of re-entry varied by child and care characteristics including age, ethnicity, mode of exit, and placement stability. Based on these associated factors, we developed a calculator that can estimate the likelihood of rapid re-entry to OHC for a group of children and could be used by social care practitioners or service planners. Our findings provide insight into which groups of children are most likely to re-enter OHC, who may benefit from additional support or ongoing monitoring.

Judicial outcome and follow up of abused child protection acts in a pediatric emergency department: 12-year experience in a third level pediatric hospital

“…We did not find difference in the time of separation, age at first out-of-home allocation, or sex. Some studies on the out-of-home care showed that reunification fails in almost 22-33% of the cases causing a re-entering of the child in the social care protection [13][14][15]. Others tried to outline likely risk factors due to the lack of reunification or the need to re-entry in the out-ofhome care after a failed reunion, showing opposing results.…”

“…A generalization of these results is very difficult due to the unique and not always measurable factors, as the severity and length of the period of maltreatment experienced. Moreover, it is debated if the outplacement is really beneficial or inconsequential for the development and wellbeing of maltreated children [15,[17][18][19].…”

Long-term mortality in mothers of infants with neonatal abstinence syndrome: A population-based parallel-cohort study in England and Ontario, Canada

“…Mortality registration records were linked to hospital records for the mother and infant. In England, de-identified data on inpatient admissions for all National Health Service (NHS) hospitals linked to Office for National Statistics mortality data were obtained from NHS Digital, linked between mother and infant using previously reported methods [30], and analyzed within the UCL Data Safe Haven, England [31]. In Ontario, hospital discharge records were obtained from the Canadian Institute for Health Information Discharge Abstract Database and the Ontario Mental Health Reporting System.…”

The economic costs of child maltreatment in UK

“…The UK survey/cohort data used in the published literature are: the National Child Development Study (NCDS), the Avon Longitudinal Study of Parents and Children, the Environmental Risk Longitudinal Twin Study (E‐Risk), and more recently the UK Biobank study. For what concerns the use of administrative data: two studies (Woodman et al., 2012; Chandan et al., 2019) have used primary care records, two studies (González‐Izquierdo et al., 2010, 2014) have used data from the Hospital Episode Statistics, two studies (Mc Grath‐Lone et al., 2016, 2017) have used administrative records on Children Looked After and two very recent studies (Murray et al., 2020a, 2020b) have used data from the Longitudinal Study; additionally, another recent study (Baldwin et al., 2020) has used the Born in Bradford cohort linked with data from the Child Protection System. This review also showed that using directly results from this literature as basis for our cost estimates was problematic, since different definitions of child maltreatment have been adopted (even in studies based on the same data, see Table of the Supplementary Material), and different methodologies and control variables have been used in the various studies.…”