Differences in ambulance attendances between children with and without an identified history of out-of-home-care

Ryan Baldwin; Susan Baidawi; Christine Grove; Tina Lam; Rowan P Ogeil; Ziad Nehme; Agatha Faulkner; Naomi Beard; Dan I Lubman; Debbie Scott

doi:10.1016/j.chiabu.2024.107086

Differences in ambulance attendances between children with and without an identified history of out-of-home-care

Child Abuse Negl. 2024 Dec:158:107086. doi: 10.1016/j.chiabu.2024.107086. Epub 2024 Oct 22.

Authors

Ryan Baldwin¹, Susan Baidawi², Christine Grove³, Tina Lam⁴, Rowan P Ogeil⁵, Ziad Nehme⁶, Agatha Faulkner⁷, Naomi Beard⁸, Dan I Lubman⁵, Debbie Scott⁹

Affiliations

¹ Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia; Deakin University, Faculty of Health School of Psychology, Geelong, Victoria, Australia; Monash Addiction Research Centre, Monash University, Frankston, Victoria, Australia. Electronic address: [email protected].
² Monash Addiction Research Centre, Monash University, Frankston, Victoria, Australia; Monash University, Faculty of Medicine Nursing and Health Sciences, Department of Social Work, Australia.
³ Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; School of Health and Biomedical Sciences, Department of Health Sciences, Psychology RMIT University, Melbourne, Australia.
⁴ Monash Addiction Research Centre, Monash University, Frankston, Victoria, Australia.
⁵ Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia; Monash Addiction Research Centre, Monash University, Frankston, Victoria, Australia.
⁶ Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Ambulance Victoria, Australia; Centre for Research and Evaluation, Ambulance Victoria, Australia; School of Public Health and Preventive Medicine, Department of Paramedicine, Monash University, Australia.
⁷ Australian Institute of Family Studies, Melbourne, Victoria, Australia.
⁸ Turning Point, Eastern Health, Richmond, Victoria, Australia.
⁹ Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia; Turning Point, Eastern Health, Richmond, Victoria, Australia; Australia Institute for Health Transformation. Deakin University, Geelong, Victoria, Australia.

PMID: 39442375
DOI: 10.1016/j.chiabu.2024.107086

Abstract

Background: Children in out-of-home-care (OOHC) are a vulnerable population, typically with complex needs, however there is minimal research examining the behavioural presentations that lead to the increased use of acute emergency care by OOHC children.

Objective: This study aimed to describe differences in lifetime complexity factors identified during ambulance attendances between children with and without an identified history of OOHC. Further, this study aimed to describe whether having an identified history of being in OOHC was associated with increased utilisation of emergency care resources and increased likelihood of multiple ambulance attendances.

Method: Electronic patient care records from ambulance attendances during the period January 2017 and June 2023 for 27,565 children 0-17 years in Victoria, Australia were examined.

Results: Children with an identified history of OOHC had a substantially higher co-occurrence of substance-related harms, violence, self-harm, suicide ideation and attempts, a developmental or intellectual disability and mental health conditions compared with children where there was no identified OOHC history. As hypothesised, logistic regression found, after controlling for all complexity factors, an identified history of OOHC increased likelihood of multiple ambulance attendances (OR = 2.65; 95 % CI: 2.17-3.24, p < .001).

Conclusions: The findings suggest children within OOHC have increasingly complex comorbidities, and this may be associated with increased emergency care utilisation. Development of tailored support to these multiple and complex needs is necessary to help reduce repeated emergency care responses for this at-risk population.

Keywords: Foster care; Mental health; Mental illness; Self-harm; Substance-related harms; Suicide.

MeSH terms

Adolescent
Ambulances* / statistics & numerical data
Child
Child, Preschool
Emergency Medical Services / statistics & numerical data
Female
Humans
Infant
Infant, Newborn
Male
Victoria / epidemiology