Potentially preventable hospitalisations for Aboriginal children with experience of out-of-home care: a data linkage study

Abstract

Objective: To compare potentially preventable hospitalisation (PPH) rates and types of conditions for Aboriginal children by exposure to out-of-home care (OOHC) and estimate the effect of first OOHC placement on PPH rates.

Methods: A retrospective longitudinal study of linked hospitalisation and child protection data for a matched cohort of Aboriginal children born in Western Australia between 2000 and 2013 using observed and predicted rates.

Results: Incidence rate of PPH bed days was 2.3 times higher for children ever-placed in OOHC than never-placed children. Diagnosed conditions showed no difference between ever and never-placed children across all ages. On average, PPH bed days reduced by 11% (95% confidence interval: 3% to 18%) following the first OOHC placement but never reached parity with never-placed children. For dental and otitis media-related PPHs, rates increased following first placement.

Conclusions: Children with experience of OOHC had greater rates of PPH bed days which persisted despite reductions following first OOHC placement.

Implications for public health: Healthcare system capacity, cultural safety, and access, as well as the material conditions of families at risk of CPS intervention, all need to be improved if rates of PPHs are to be reduced.

Keywords: Aboriginal children; Western Australia; data linkage; out-of-home care; potentially preventable hospitalisation.