英格兰儿童健康访视接触情况的变化：使用行政数据（社区服务数据集，CSDS）对 2-2 岁半审查的横断面分析。

Variation in health visiting contacts for children in England: cross-sectional analysis of the 2-2½ year review using administrative data (Community Services Dataset, CSDS).

机构信息

Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK, London, UK.

Department of Social Policy and Intervention, University of Oxford, Oxford, UK.

出版信息

BMJ Open. 2022 Feb 22;12(2):e053884. doi: 10.1136/bmjopen-2021-053884.

DOI:10.1136/bmjopen-2021-053884

PMID:35193912

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8867374/

Abstract

OBJECTIVE

The 2-2½ year universal health visiting review in England is a key time point for assessing child development and promoting school readiness. We aimed to ascertain which children were least likely to receive their 2-2½ year review and whether there were additional non-mandated contacts for children who missed this review.

DESIGN, SETTING, PARTICIPANTS: Cross-sectional analysis of the 2-2½ year review and additional health visiting contacts for 181 130 children aged 2 in England 2018/2019, stratified by ethnicity, deprivation, safeguarding vulnerability indicator and Looked After Child status.

ANALYSIS

We used data from 33 local authorities submitting highly complete data on health visiting contacts to the Community Services Dataset. We calculated the percentage of children with a recorded 2-2½ year review and/or any additional health visiting contacts and average number of contacts, by child characteristic.

RESULTS

The most deprived children were slightly less likely to receive a 2-2½ year review than the least deprived children (72% vs 78%) and Looked After Children much less likely, compared with other children (44% vs 69%). When all additional contacts were included, the pattern was reversed (deprivation) or disappeared (Looked After children). A substantial proportion of all children (24%), children with a 'safeguarding vulnerability' (22%) and Looked After children (29%) did not have a record of either a 2-2½ year review or any other face-to-face contact in the year.

CONCLUSIONS

A substantial minority of children aged 2 with known vulnerabilities did not see the health visiting team at all in the year. Some higher need children (eg, deprived and Looked After) appeared to be seeing the health visiting team but not receiving their mandated health review. Further work is needed to establish the reasons for this, and potential solutions. There is an urgent need to improve the quality of national health visiting data.

摘要

目的

英格兰的 2-2.5 岁全民健康访视审查是评估儿童发育和促进入学准备的关键时间点。我们旨在确定哪些儿童最不可能接受 2-2.5 岁的审查，以及对于错过此次审查的儿童是否有额外的非强制性预约。

设计、地点、参与者：2018/2019 年英格兰对 181130 名 2 岁儿童的 2-2.5 岁审查和额外健康访视接触情况进行的横断面分析，根据种族、贫困程度、保护脆弱性指标和被照顾儿童状况进行分层。

分析

我们使用了向社区服务数据集提交高度完整健康访视接触数据的 33 个地方当局的数据。我们根据儿童特征计算了有记录的 2-2.5 岁审查和/或任何额外健康访视接触的儿童比例以及平均接触次数。

结果

最贫困的儿童接受 2-2.5 岁审查的可能性略低于最不贫困的儿童（72%对 78%），与其他儿童相比，被照顾儿童的可能性更小（44%对 69%）。当包括所有额外的接触时，模式发生了反转（贫困）或消失（被照顾儿童）。相当一部分儿童（24%）、有“保护脆弱性”的儿童（22%）和被照顾儿童（29%）在这一年中没有记录到 2-2.5 岁审查或任何其他面对面的接触。