Potentially preventable hospitalisations in children: a comparison of definitions

Procter, Alexandra M; Pilkington, Rhiannon; Lynch, John; Smithers, Lisa G.; Chittleborough, Catherine

doi:10.1136/archdischild-2019-316945

Cited by 9 publications

(18 citation statements)

References 18 publications

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“…The organization follows best practice guidelines which initially include deduplication processes and deterministic linkage, followed by probabilistic linkage using industry-leading algorithms, and with detailed clerical review. In a recently published paper using data from SA-NT DataLink, it was stated that Australian data linkage systems estimate linkage error rate at approximately 0.1%–0.5% (Procter et al, in press). The data sets made available to the researchers included child protection data from the SA Department for Child Protection (DCP), child birth information from the SA Births Registry and the SA Perinatal Statistics Collection, and education data from the SA Department for Education (DfE).…”

Section: Methodsmentioning

confidence: 99%

School Absenteeism Associated With Child Protection System Involvement, Maltreatment Type, and Time in Out-of-Home Care

et al. 2020

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Greater school absenteeism is associated with numerous negative educational outcomes. We used a retrospective cohort design with linked administrative data on 296,422 children to examine the relationship between school absenteeism and child protection system (CPS) involvement. Children with substantiated maltreatment had 4.1 times more unexplained and problem absences than children with no CPS involvement. In multivariate analyses, children with substantiated maltreatment had significantly greater “chronic” truancy ( OR = 3.41) and less “acceptable” levels of absences ( OR = 0.74) compared to children with no CPS involvement. Greater absenteeism was seen for children with substantiated neglect and who had their first CPS notification earlier in life. Being in out-of-home care for 3+ years was a protective factor for children who had a CPS notification before age 5. Additional adversities had a strong additive effect with CPS involvement on absenteeism and chronic truancy. This study demonstrates the potential scope for reducing problem absenteeism and helps inform the public debate regarding how the type and timing of CPS involvement might ameliorate or exacerbate harm for children.

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Section: Methodsmentioning

confidence: 99%

School Absenteeism Associated With Child Protection System Involvement, Maltreatment Type, and Time in Out-of-Home Care

et al. 2020

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“…15 A higher proportion of IWC children experienced a PPH which are also associated with socioeconomic disadvantage. 40 While IWC children were more likely to experience a hospitalisation relating to a CCC, the overall proportion was small (age 11-15 years: 1.9%; age 16-20 years: 2.2%).…”

Section: Discussionmentioning

confidence: 88%

“…While welfare receipt has been associated with poorer mental health outcomes, 11,24,26,29 our study showed IWC children experience even higher mental health hospitalisation rates compared to WC experienced only in one generation. We expected IWC children to have higher injury hospitalisation rates given injury hospitalisation is more frequent in children from the most disadvantaged backgrounds 40,41 but this had not been quantified before. IWC children having higher hospitalisation rates related to pregnancy and childbirth reflects the inclusion of welfare payments associated with parenting.…”

Section: All Cause Hospitalisationsmentioning

confidence: 99%

“…39 Potentially preventable hospitalisations (PPHs) were calculated under a child-centric definition for admission at ages 11-14 and under the standard Australian definition (best suited to adults) at ages 15-20. 40 Primary diagnosis codes used to identify paediatric Complex Chronic Conditions (CCCs) were adapted to the ICD-10-AM coding system. 41…”

Section: Inpatient Hospitalisation Data Records Age At Admission and The International Statisticalmentioning

confidence: 99%

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The hospital burden of intergenerational contact with the welfare system:A whole-of-population liked data study

Procter

Chittleborough

Pilkington

et al. 2021

Preprint

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BackgroundIntergenerational welfare contact (IWC) is a policy issue because of the personal and social costs of intergenerational disadvantage. We estimated the hospital burden of IWC for children aged 11-20 years.MethodsThis linked data study of children born in South Australia, 1991-1995 (n=94,358), and their parent/s (n=143,814) used de-identified data from the Better Evidence Better Outcomes Linked Data platform. Using Australian Government Centrelink data, welfare contact (WC) was defined as parent/s receiving a means-tested welfare payment (low-income, unemployment, disability or caring) when children were aged 11-15, or children receiving payment at ages 16-20. IWC was WC occurring in both parent and child generations. Children were classified as: No WC, parent only WC, child only WC, or IWC. Hospitalisation rates and cumulative incidence were estimated by age and WC group.FindingsIWC affected 34.9% of children, who had the highest hospitalisation rate (133.5 per 1,000 person-years) compared to no WC (46.1 per 1,000 person-years), parent only WC (75.0 per 1,000 person-years), and child only WC (87.6 per 1,000 person-years). Of all IWC children, 43.0% experienced at least one hospitalisation between 11-20, frequently related to injury, mental health, and pregnancy.InterpretationChildren experiencing IWC represent a third of the population aged 11-20. Compared to children with parent-only WC, IWC children had 78% higher hospitalisation rates from age 11 to 20, accounting for over half of all hospitalisations in this age group. Frequent IWC hospitalisation causes were injuries, mental health, and pregnancy.FundingMedical Research Future Fund, National Health and Medical Research Council, Westpac Scholars Trust.

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“…Another important health outcome is hospitalisations for conditions considered potentially avoidable with the provision of ‘timely and adequate non-hospital care’ (p375) 9. Examples of these conditions include respiratory conditions, gastrointestinal disease and vaccine-preventable diseases 10 11.…”

Section: Introductionmentioning

confidence: 99%

Residential mobility and potentially avoidable hospitalisations in a population-based cohort of New Zealand children

Kim

Robertson

Carr

et al. 2022

J Epidemiol Community Health

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BackgroundResidential moves are common in early childhood and associations have been found between residential mobility and adverse child health and well-being outcomes. Although there are studies on potentially avoidable hospitalisations (PAH) in children, few have examined PAH in relation to residential mobility. Our aim, therefore, was to investigate residential mobility and PAH in a population-based cohort of New Zealand children.MethodsUsing a retrospective cohort design, we analysed data from the Integrated Data Infrastructure for a cohort of 314 283 children born since the start of 2004, who had at least one residential address recorded by 2 years of age. Residential mobility was derived from address data and PAH were determined from hospital discharge data.ResultsHalf of the cohort children (52%) experienced at least one residential move by 2 years of age, and 22% experienced two or more moves. Fifteen per cent of the cohort experienced one or more PAH between 2 and 4 years of age. A linear association between residential mobility and PAH was found (relative risk (RR)=1.18, CI 1.17 to 1.19) and this remained robust when adjusting for several covariates. Sensitivity analyses for ambulatory care sensitive hospitalisations (ACSH) and PAH attributable to the housing/physical environment (PAH-HE) produced results very similar to those for PAH (ACSH: adjusted RR (aRR)=1.10, CI 1.09 to 1.11; PAH-HE: aRR=1.11, CI 1.10 to 1.12).ConclusionThis study found a linear association between higher residential mobility and an increased likelihood of PAH in young children. Avenues for further investigation are suggested.

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Potentially preventable hospitalisations in children: a comparison of definitions

Cited by 9 publications

References 18 publications

School Absenteeism Associated With Child Protection System Involvement, Maltreatment Type, and Time in Out-of-Home Care

School Absenteeism Associated With Child Protection System Involvement, Maltreatment Type, and Time in Out-of-Home Care

The hospital burden of intergenerational contact with the welfare system:A whole-of-population liked data study

Residential mobility and potentially avoidable hospitalisations in a population-based cohort of New Zealand children

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