Changes in first entry to out-of-home care from 1992 to 2012 among children in England
Changes in first entry to out-of-home care from 1992 to 2012 among children in England
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DOI：
10.1016/j.chiabu.2015.10.020
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发表时间：
2016-01-01
影响因子：
4.8
通讯作者：
Gilbert, Ruth
中科院分区：
文献类型：
--
作者：
Mc Grath-Lone, Louise;Dearden, Lorraine;Gilbert, Ruth
安置在家庭外照顾（OHC）表明严重的童年逆境，并与多种不良后果。每年有0.5%的英格兰儿童住在OHC，但缺乏证据表明儿童时期进入的累积比例以及随着时间的推移如何变化。我们测量了1992年至2011年间出生的儿童进入OHC的比例，包括随时间推移的入学率变化，并使用分解方法探索了这些变化的决定因素。我们还描述了放置类型，持续时间和稳定性的变化。到18岁时，1992-94年出生的儿童中有3.3%进入OHC。这一比例因族裔而异（2001- 2003年出生的白色儿童的1.6%与黑人儿童的4.5%在9岁时进入OHC，95% CI [1.5-1.7]和[4.4-4.6]，p < 0.001），并随时间增加（2009- 2011年出生的儿童中有0.8%在1岁时进入OHC，而1992-94年出生的儿童中有0.5%进入OHC，95% CI [0.7-0.9]和[0.4-0.6]，p < 0.001）。这一总体增长主要是由于白色儿童入学率的增加，而不是由于人口族裔组成的同时变化。在英格兰，进入OHC的儿童比例正在增加，他们接受的护理特点正在发生变化，干预时间更早，安置更稳定。需要进一步研究，以了解这些变化在实践中的原因，以及它们是否具有成本效益，可持续性，并改善儿童和社会的成果。(C)2015年，作者。爱思唯尔有限公司出版
Placement in out-of-home care (OHC) indicates serious childhood adversity and is associated with multiple adverse outcomes. Each year 0.5% of children in England live in OHC but evidence is lacking on the cumulative proportion who enter during childhood and how this varies overtime. We measured the proportion of children born between 1992 and 2011 who entered OHC, including variation in rates of entry overtime, and explored the determinants of these changes using decomposition methods. We also described changes in placement type, duration and stability. By age 18,3.3% of children born 1992-94 entered OHC. This proportion varied by ethnicity (1.6% of White vs. 4.5% of Black children born 2001-03 entered OHC by age 9, 95% CI [1.5-1.7] and [4.4-4.6], p < 0.001) and increased over time (0.8% of children born 2009-11 entered OHC by age 1 vs. 0.5% born 1992-94, 95% CI [0.7-0.9] and [0.4-0.6], p < 0.001). This overall increase was driven primarily by the increased rate of entry among White children and not by concurrent changes in the population's ethnic composition. The proportion of children entering OHC in England is increasing and characteristics of the care they receive are changing with earlier intervention and longer, more stable placements. Further research is required to understand the reasons for these changes in practice and whether they are cost-effective, sustainable, and improve outcomes for children and society. (C) 2015 The Authors. Published by Elsevier Ltd.