Timeliness and extent of health service use by Victorian (Australian) children within first year after entry to out-of-home care: Retrospective data linkage cohort study.

• This is the first Australian health service utilisation data for children in out-of-home care (OOHC). • Very few children attended all recommended services for routine and timely health assessment. • Most children entering OOHC saw a General Practitioner within one year of entering care. • One in three children saw a GP within the recommended one month of entering OOHC. • This study provides benchmarking data for monitoring of future system improvements and research. Children in out-of-home care (OOHC) have high rates of health needs; consequently, many countries (including Australia) have policies and/or statutory requirements for health assessment upon OOHC entry. However, Australia has no data on health service utilisation or timeliness. We aimed to describe timing and extent of health service utilisation by children in the state of Victoria upon entry to OOHC, exploring demographic and specific service exposure variations. Population-based retrospective cohort study. Data from Victoria's Child Protection dataset (2010–2015) were linked to federal (Medicare Billing Schedule (MBS)) and state (Community Health, Mental Health, Community Dental and outpatient clinic) health datasets. Victorian first-time entrants to OOHC (April 2010 – December 2015): 6,201 0 – 12 year old children. Proportion visiting health services within 12 months of entering care; proportion visiting within recommended timeframes. Descriptive statistics, multivariable logistic regression, and Kaplan-Meier survival curves. Pre-post health service use following the limited introduction of health assessment clinics was compared with trends elsewhere in Victoria. 5,676 (92%) children were successfully linked to the MBS dataset. 41 children (<1%) had attended all recommended health services within 12 months of OOHC entry. While most (90%) within the linked cohort visited a General Practitioner, only 37% attended within the recommended 30 days. Around a third visited a paediatrician; fewer than 20% visited a community dentist, optometrist, or audiologist. Children in foster care had higher odds of attending services than those in kinship care. The pre-post trends in health service use in areas where a dedicated assessment clinic commenced were more positive than for areas without the clinic. A minority of Victorian children in OOHC accessed health services according to national or state (Victorian) standards, very few in a timely manner. Children in kinship care were less likely to meet guidelines. [ABSTRACT FROM AUTHOR]