G346 Cyphp evelina london new care model to improve health, healthcare quality, and patterns of service use among children and young people

2019 ◽  
Author(s):  
I Wolfe ◽  
C Lemer ◽  
M Heys ◽  
A Ingrassia ◽  
J Newham ◽  
...  
Keyword(s):  
Young People ◽  
Service Use ◽  
Healthcare Quality ◽  
Care Model ◽  
Children And Young People ◽  
Improve Health

scholarly journals Interventions and practice models for improving health and psychosocial outcomes of children and young people in out-of-home care: protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031362
Author(s):  
Emma Galvin ◽  
Renée O'donnell ◽  
Helen Skouteris ◽  
Nick Halfpenny ◽  
Aya Mousa
Keyword(s):  
Systematic Review ◽  
Young People ◽  
Home Care ◽  
Psychosocial Outcomes ◽  
Children And Young People ◽  
Out Of Home Care ◽  
Practice Models ◽  
Outcomes For Children ◽  
The Impact ◽  
Improve Health

IntroductionChildren and young people placed in out-of-home care (OoHC) are often affected by a history of trauma and adverse childhood experiences. Trauma in early childhood can impact on children’s health and psychosocial development, whereas early interventions can improve children’s development and placement stability. Although several interventions and practice models have been developed to improve health and psychosocial outcomes for children and young people in OoHC, there remains a lack of rigorous research examining the impact of these interventions in OoHC settings, as there are no systematic reviews examining the impact these interventions and practice models have on the children and young people they serve. We aim to conduct a comprehensive systematic review to examine the effectiveness of interventions and practice models for improving health and psychosocial outcomes in children and young people living in OoHC and to identify relevant knowledge gaps.Methods and analysisMajor electronic databases including Medline, Medline in-process and other non-indexed citations, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Sociological Abstracts and all Evidence-Based Medicine Reviews incorporating: Cochrane Database of Systematic Reviews, American College of PhysiciansJournal Club, Database of Abstracts of Reviews of Effects,Cochrane Central Register of Controlled Trials, CochraneMethodology Register, Health Technology Assessment and National Health Service Economic Evaluation Database, will be systematically searched for any studies published between 2008 and 2018 of interventions and practice models developed to improve health and psychosocial outcomes for children and young people in OoHC. Two independent reviewers will assess titles and abstracts for eligibility according to prespecified selection criteria and will perform data extraction and quality appraisal. Meta-analyses and/or metaregression will be conducted where appropriate.Ethics and disseminationThis study will not collect primary data and formal ethical approval is therefore not required. Findings from this systematic review will be disseminated in a peer-reviewed publication and conference presentations.PROSPERO registration numberCRD42019115082.

scholarly journals Impacts of school closures on physical and mental health of children and young people: a systematic review

2021 ◽  
Author(s):  
Russell Viner ◽  
Simon Russell ◽  
Rosella Saulle ◽  
Helen Croker ◽  
Claire Stansfeld ◽  
...  
Keyword(s):  
Mental Health ◽  
Systematic Review ◽  
Young People ◽  
Child Protection ◽  
Service Use ◽  
Hospital Admissions ◽  
Vulnerable Groups ◽  
High Quality ◽  
School Closures ◽  
Children And Young People

AbstractBackgroundThe well-documented links between education and health mean that school closures during the COVID-19 pandemic are likely to be associated with significant health harms to children and young people (CYP). A systematic review of the evidence is needed to inform policy decisions around school closures and re-openings during the pandemic.MethodsWe undertook a high-quality systematic review of observational quantitative studies (published or preprint) of the impacts of school closures (for any reason) on the health, wellbeing and educational outcomes of CYP, excluding impacts of closure on transmission of infection (PROSPERO CRD42020181658). We used a machine learning approach for screening articles, with decisions on inclusion and data extraction performed independently by 2 researchers. Quality was assessed for study type. A narrative synthesis of results was undertaken as data did not allow meta-analysis.Results16,817 records were screened, of which 151 were reviewed in full-text and 72 studies were included from 20 countries. 33% were cohort studies using historical control periods; 19% pre-post studies; and 46% cross-sectional studies which assessed change by comparison with population reference data. 63% were high-quality, 25% medium-quality and 13% low-quality. Cause of closure in all studies was the first COVID-19 pandemic wave with the exception of 5 influenza studies and 1 teacher strike.27 studies concerning mental health identified considerable impacts across emotional, behavioural and restlessness/inattention problems; 18-60% of CYP scored above risk thresholds for distress, particularly anxiety and depressive symptoms. Two studies reported non-significant rises in suicide rates. Self-harm and psychiatric attendances were markedly reduced, indicating a rise in unmet mental health need. Child protection referrals fell 27-39%, with a halving of the expected number of referrals originating in schools.19 studies concerning health service use showed marked reductions in emergency department (ED) presentations and hospital admissions, with evidence of delayed presentations and potential widening of inequalities in vaccination coverage. Data suggested marked rises in screen-time and social media use and reductions in physical activity however data on sleep and diet were inconclusive. Available data suggested likely higher harms in CYP from more deprived populations.ConclusionsSchool closures as part of broader social distancing measures are associated with considerable harms to CYP health and wellbeing. Available data are short-term and longer-term harms are likely to be magnified by further school closures. Data are urgently needed on longer-term impacts using strong research designs, particularly amongst vulnerable groups. These findings are important for policy-makers seeking to balance the risks of transmission through school-aged children with the harms of closing schools.

scholarly journals Patterns of healthcare utilisation in children and young people: a retrospective cohort study using routinely collected healthcare data in Northwest London

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e050847
Author(s):  
Thomas Beaney ◽  
Jonathan Clarke ◽  
Thomas Woodcock ◽  
Rachel McCarthy ◽  
Kavitha Saravanakumar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Young People ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Service Use ◽  
Healthcare Utilisation ◽  
Secondary Outcome ◽  
Long Term Conditions ◽  
Children And Young People ◽  
Healthcare Data

ObjectivesWith a growing role for health services in managing population health, there is a need for early identification of populations with high need. Segmentation approaches partition the population based on demographics, long-term conditions (LTCs) or healthcare utilisation but have mostly been applied to adults. Our study uses segmentation methods to distinguish patterns of healthcare utilisation in children and young people (CYP) and to explore predictors of segment membership.DesignA retrospective cohort study.SettingRoutinely collected primary and secondary healthcare data in Northwest London from the Discover database.Participants378 309 CYP aged 0–15 years registered to a general practice in Northwest London with 1 full year of follow-up.Primary and secondary outcome measuresAssignment of each participant to a segment defined by seven healthcare variables representing primary and secondary care attendances, and description of utilisation patterns by segment. Predictors of segment membership described by age, sex, ethnicity, deprivation and LTCs.ResultsParticipants were grouped into six segments based on healthcare utilisation. Three segments predominantly used primary care, two moderate utilisation segments differed in use of emergency or elective care, and a high utilisation segment, representing 16 632 (4.4%) children accounted for the highest mean presentations across all service types. The two smallest segments, representing 13.3% of the population, accounted for 62.5% of total costs. Younger age, residence in areas of higher deprivation and the presence of one or more LTCs were associated with membership of higher utilisation segments, but 75.0% of those in the highest utilisation segment had no LTC.ConclusionsThis article identifies six segments of healthcare utilisation in CYP and predictors of segment membership. Demographics and LTCs may not explain utilisation patterns as strongly as in adults, which may limit the use of routine data in predicting utilisation and suggest children have less well-defined trajectories of service use than adults.

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