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Updated: Feb 6, 2026

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Healthcare utilisation among children in contact with social services in England: An interrupted time series using

Eliazar Luna1, Lucy J Griffiths2, Karen Broadhurst Obe3

  • 1UCL Great Ormond Street Institute of Child Health, University College London, 30 Guilford St, WC1N 1EH, London, UK.

Child Abuse & Neglect
|February 4, 2026
PubMed

Insights

Children

Area of Science:

  • Public Health
  • Child Welfare
  • Healthcare Services Research

Background:

  • Children interacting with children's social care (CSC) services exhibit high hospital use.
  • Understanding healthcare utilization patterns before and after CSC referral is limited.

Purpose of the Study:

  • To analyze healthcare utilization trends in the two years preceding and following CSC referral.
  • To investigate changes in planned and unplanned hospital contacts post-referral.

Main Methods:

  • Retrospective cohort study utilizing linked ECHILD health and social care data in England (2009-2018).
  • Comparison of monthly hospital contact rates (planned vs. unplanned) for Children in Need, Children under Protection Plans, and Children Looked After against matched controls.
  • Interrupted time series analysis to assess healthcare utilization changes post-referral.

Main Results:

  • Over 1.4 million children experienced >12 million hospital contacts; all CSC groups had double the contacts of peers.
  • Healthcare utilization significantly increased before CSC referral, peaking around the time of referral.
  • Post-referral, planned care increased while unplanned care decreased, with mental health as a primary reason for contact.

Conclusions:

  • CSC referral represents a critical juncture in children's healthcare utilization, signaling a transition from unplanned to planned care.
  • This shift suggests improved engagement with health services and coordinated support for vulnerable children and families.
Abstract

Keywords:
Administrative dataChildren's social careHealthcare utilisationHospital contactsInterrupted time series

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