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Health service use in families where children enter public care : a nested case control study using the General Practice Research Database
- Source :
- BMC Health Services Research, Vol 12, Iss 1, p 65 (2012), BMC Health Services Research
- Publication Year :
- 2012
- Publisher :
- Biomed central, 2012.
-
Abstract
- Background At least 3% of children spend some of their childhood in public care and, as a group, have poor outcomes across a range of education, employment, health and social care outcomes. Research, using social care or government datasets, has identified a number of risk factors associated with children entering public care but the utility of risk factors in clinical practice is not established. This paper uses routine primary health care data to see if risk factors for children entering public care can be identified in clinical practice. Methods A nested case control methodology using routine primary care data from the United Kingdom. Health service use data were extracted for the 12 months before the case child entered public care and compared with 12 months of data for four control mother child pairs per case pair, matched on the age and sex of the child and the general practice. Exposures of interest were developed from a systematic review of the literature on risk factors associated with children entering public care. Results Conditional logistic regression was used to investigate the combined effect of more than one exposure of interest. Maternal mental illness (OR 2.51, 95% CI 1.55-4.05), maternal age at birth of the child, socio-economic status (5th quintile vs. 1st quintile OR 7.14, 95% CI 2.92-17.4), maternal drug use (OR 28.8, 95% CI 2.29-363), non attendance at appointments (OR 2.42, 95% CI 1.42-4.14), child mental illness (OR 2.65, 95% CI 1.42-4.96) and child admission to hospital (OR 3.31, 95% CI 1.21-9.02) were all significantly associated with children entering public care. Maternal use of primary care contraception services was negatively associated with children entering public care (OR 0.52, 95% CI 0.31-0.87). Conclusions Differences in health service use can be identified from routine primary care data in mother child pairs where children enter public care after controlling for maternal age and socio-economic status. The interaction between different risk factors needs testing in a cumulative risk model using longitudinal datasets.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
Databases, Factual
RJ
General Practice
Maternal-Child Health Centers
Mothers
Health informatics
Health administration
Young Adult
Risk Factors
Surveys and Questionnaires
Health care
medicine
HQ
Humans
Child
Family Health
Government
Public Sector
Primary Health Care
business.industry
Mental Disorders
Public health
Nursing research
Health Policy
lcsh:Public aspects of medicine
Infant
lcsh:RA1-1270
Middle Aged
Mental illness
medicine.disease
United Kingdom
Hospitalization
Logistic Models
Social Class
Case-Control Studies
Child, Preschool
Family medicine
Nested case-control study
Female
Health Services Research
business
Research Article
Maternal Age
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research, Vol 12, Iss 1, p 65 (2012), BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....047415e2d30c706ef846f037922348a0