Changes in adolescents’ planned hospital care during the COVID-19 pandemic: analysis of linked administrative data
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Abstract
To describe changes in planned hospital care during the pandemic for vulnerable adolescents receiving children’s social care (CSC) services or special educational needs (SEN) support, relative to their peers.
Design
Observational cohort in the Education and Child Health Insights from Linked Data database (linked de-identified administrative health, education and social care records of all children in England).
Study population
All secondary school pupils in years 7–11 in academic year 2019/2020 (N=3 030 235).
Main exposure
Receiving SEN support or CSC services.
Main outcomes
Changes in outpatient attendances and planned hospital admissions during the first 9 months of the pandemic (23 March–31 December 2020), estimated by comparing predicted with observed numbers and rates per 1000 child-years.
Results
A fifth of pupils (20.5%) received some form of statutory support: 14.2% received SEN support only, 3.6% received CSC services only and 2.7% received both. Decreases in planned hospital care were greater for these vulnerable adolescents than their peers: −290 vs −225 per 1000 child-years for outpatient attendances and −36 vs −16 per 1000 child-years for planned admissions. Overall, 21% of adolescents who were vulnerable disproportionately bore 25% of the decrease in outpatient attendances and 37% of the decrease in planned hospital admissions. Vulnerable adolescents were less likely than their peers to have face-to-face outpatient care.
Conclusion
These findings indicate that socially vulnerable groups of children have high health needs, which may need to be prioritised to ensure equitable provision, including for catch-up of planned care postpandemic.
Article activity feed
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SciScore for 10.1101/2021.11.29.21266996: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:A limitation of this analysis is that it only looked at deficits in planned hospital care during the first nine months of the pandemic as experienced by young people aged 11 to 16 years, focusing on those whose vulnerabilities could be readily defined from …
SciScore for 10.1101/2021.11.29.21266996: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics not detected. Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:A limitation of this analysis is that it only looked at deficits in planned hospital care during the first nine months of the pandemic as experienced by young people aged 11 to 16 years, focusing on those whose vulnerabilities could be readily defined from administrative education and social care data. The true extent of the deficits in planned hospital care that occurred among all vulnerable children and young people throughout the course of the pandemic will be much greater than our estimates.
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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