Search

Youth homelessness remains an ongoing public health issue worldwide. We aimed to describe the burden of emergency department (ED) presentations and hospitalizations among a South Australian population of young people in contact with specialist homelessness services (SHS). This whole-of-population study used de-identified, linked administrative data from the Better Evidence Better Outcomes Linked Data (BEBOLD) platform on all individuals born between 1996 and 1998 (N = 57,509). The Homelessness2Home data collection was used to identify 2,269 young people in contact with SHS at ages 16–17 years. We followed these 57,509 individuals to age 18–19 years and compared ED presentations and hospital separations related to mental health, self-harm, drug and alcohol, injury, oral health, respiratory conditions, diabetes, pregnancy, and potentially preventable hospitalizations between those in contact and not in contact with SHS. Four percent of young people had contact with SHS at ages 16–17 years. Young people who had contact with SHS were 2 and 3 times more likely to have presented to an ED and hospital respectively, compared to those who did not contact SHS. This accounted for 13% of all ED presentations and 16% of all hospitalizations in this age group. Excess burden causes included mental health, self-harm, drug and alcohol, diabetes, and pregnancy. On average, young people in contact with SHS experienced an increased length of stay in ED (+0.6 hours) and hospital (+0.7 days) per presentation, and were more likely to not wait for treatment in ED and to self-discharge from hospital. The 4% of young people who contacted SHS at ages 16–17 years accounted for 13% and 16% of all ED presentations and hospitalizations respectively at age 18–19 years. Prioritizing access to stable housing and primary health-care services for adolescents in contact with SHS in Australia could improve health outcomes and reduce health-care costs. [ABSTRACT FROM AUTHOR]

Researchers and policymakers have called for a shift from incident-driven statutory child protection responses to greater investment in coordinated system-wide child and family focused approaches to preventing child maltreatment. However, system-wide capacity to prevent maltreatment is limited without an intelligent information infrastructure that is able to routinely examine child and family focused outcomes, and overall system performance to increase our understanding of what works. The purpose of this article is to investigate the current state of indicators for child protection, health, development and wellbeing, and to propose indicator domains that are needed for an intelligent information infrastructure in a prevention-focused child protection system. A non-systematic narrative review was undertaken to explore commonly used indicators. Examples are drawn from high-income countries with well-developed child protection agencies. Our analysis shows that process indicators that measure within-agency activities are most commonly used. Indicators that measure outcomes in children are less common, and even less common are indicators linking system processes to child and family outcomes. Capacity to understand the success of system-wide prevention of child maltreatment is limited by siloed data collection and information systems. Three information indicator domains need to be routinely collected and linked. First, within-agency processes (what activities occurred); second, warm handover (referrals between agencies) and therapeutic dose of interventions; and third, child and family wellbeing outcomes. An intelligent information infrastructure spanning these domains would increase capacity to understand whole-of-system efforts to prevent child maltreatment. [ABSTRACT FROM AUTHOR]