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Careful: An administrative child welfare and electronic health records linked dataset
Sarah J Beal1,2, Katie Nause2, Robert T Ammerman1,2
1Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH 45229-3036 USA.
Insights
This study links child welfare and health records for 2,814 youth in Ohio
Area of Science:
- Child Welfare Research
- Pediatric Health Services
- Public Health Data Linkage
Background:
- Children in child protective services (CPS) custody often have complex health needs.
- Understanding these needs requires integrated data from child welfare and healthcare systems.
- Previous research has been limited by fragmented data sources.
Purpose of the Study:
- To describe the health needs and healthcare utilization of youth in CPS custody.
- To examine the relationship between health status, healthcare use, and placement stability.
- To create a comprehensive dataset linking child welfare and electronic health records for research.
Main Methods:
- Linked child welfare administrative data with electronic health records (EHR) for 2,814 youth (ages 4-20) in Hamilton County, Ohio (2012-2017).
- Extracted data on demographics, custody status, placement details, diagnoses, medications, and healthcare encounters.
- Successfully linked 99.1% of records for analysis.
Main Results:
- The linked dataset provides a comprehensive view of medical needs for school-aged children in CPS custody.
- Enables analysis of health concerns, healthcare frequency, and placement stability.
- Data are generalizable to similar urban communities with academic medical centers.
Conclusions:
- Integrated child welfare and EHR data offer valuable insights into the health of children in foster care.
- This approach can inform interventions and improve health outcomes for vulnerable youth.
- De-identified data will be available to researchers upon request.
Abstract:
Between 2012 and 2017, N = 2814 youth between the ages of 4 and 20 were in child protective services (CPS) custody in Hamilton County, Ohio, and placed in out-of-home care. Child welfare administrative records were extracted and linked to electronic health records for all encounters at Cincinnati Children's Hospital Medical Center, with n = 2787 (99.1%) of records successfully linked prior to de-identifying the data for research purposes. Child welfare administrative data fields in the dataset include demographics, dates of entry into and exit from protective custody and out-of-home care, reasons for entry into custody, dates of placement changes, reasons for placement changes, and types of placement (e.g., foster home, kinship home, group home, residential treatment, independent living). Electronic health records (EHR) data fields include demographics, all inpatient and outpatient encounters with medications, diagnoses, screening results, laboratory test results, flowsheet data, and problem list entries. Data have been coded to capture broader categories of health needs and encounter details, medications, and other health concerns. Due to the high representation of children in CPS custody and out-of-home care who are also represented in the EHR data, this dataset provides a comprehensive view of the medical needs and health concerns for school-aged children in CPS custody in an entire county. As a result, these data can be useful for understanding the emergence of global and specific health concerns, frequency of healthcare use, and placement stability for all youth in CPS custody in this community, accounting for variation due to other health and child welfare factors. These data are likely generalizable to other mid-sized urban communities where academic medical centers provide healthcare for children in CPS custody. De-identified data may be made available to other researchers with approved data transfer agreements between academic institutions in place.
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