McLean Karen, Hiscock Harriet, Scott Dorothy, Goldfeld Sharon
Policy and Equity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2021 Jan;57(1):132-139. doi: 10.1111/jpc.15157. Epub 2020 Sep 19.
To explore the experiences of Victorian foster and kinship carers in accessing health services for children in their care and to quantify the frequency of potential barriers to health care.
On-line survey co-designed with the Foster Care Association of Victoria measuring carer-reported health service engagement by a child/young person in their care, ease of service access, time to receiving Medicare number and out-of-pocket health-related costs. A total of 239 foster and 51 kinship carers were recruited through email and social media by carer support agencies.
In total, 90% of children/young people had engaged with a general practitioner. Most had engaged with dental (75%), paediatric (72%), optometry (61%) and audiology (54%) services. Mental health services were most likely to be needed but not yet received. Neither carer education nor socio-economic status was associated with likelihood of service engagement. Carers reported that it was hardest to get appointments with mental health and paediatric services. Twenty-seven percent had waited to see a health service because of delays in carers receiving their Medicare number. Sixty percent of carers had paid out-of-pocket for health services; 78% of these had not been reimbursed.
Victorian foster and kinship carers report high health service use for children and young people in their care. Mental health services were the hardest to access with the largest gap between identified need and service use. Timely access to Medicare numbers and financial support are barriers to access that could be addressed. The development of integrated paediatric health care and clinicians co-located with child protection could also assist.
探讨维多利亚州寄养和亲属照料者在为其所照料儿童获取医疗服务方面的经历，并量化医疗保健潜在障碍的出现频率。
与维多利亚州寄养照料协会共同设计在线调查问卷，用以衡量照料者报告的其所照料儿童/青少年的医疗服务参与情况、服务获取的难易程度、获取医疗保险卡号的时间以及自付的与健康相关的费用。照料者支持机构通过电子邮件和社交媒体共招募了239名寄养照料者和51名亲属照料者。
总体而言，90%的儿童/青少年曾与全科医生接触。大多数人还接触过牙科（75%）、儿科（72%）、验光（61%）和听力（54%）服务。心理健康服务最有可能需要但尚未获得。照料者的教育程度和社会经济地位均与服务参与的可能性无关。照料者报告称，最难获得心理健康和儿科服务的预约。27%的人因照料者获取医疗保险卡号延迟而等待就医。60%的照料者自掏腰包支付医疗服务费用；其中78%未得到报销。
维多利亚州的寄养和亲属照料者报告称，他们为其所照料的儿童和青少年提供了大量医疗服务。心理健康服务最难获得，在已确定的需求和服务使用之间差距最大。及时获取医疗保险卡号和经济支持是可以解决的就医障碍。发展综合儿科医疗保健以及让临床医生与儿童保护机构同处一地也会有所帮助。
