You are here

Article Text

Article menu

Download PDFPDF

XML
Public health
Research
Trends in the coverage of ‘universal’ child health reviews: observational study using routinely available data
  1. Rachael Wood1,
  2. Alex Stirling2,
  3. Claire Nolan1,
  4. Jim Chalmers1,
  5. Mitch Blair3
  1. 1Information Services Division, NHS National Services Scotland, Edinburgh, UK
  2. 2Department of Public Health, NHS Greater Glasgow and Clyde, Glasgow, UK
  3. 3River Island Academic Centre for Paediatrics and Child Health, Imperial College London, Harrow, Middlesex, UK
  1. Correspondence to Dr Rachael Wood; rachaelwood{at}nhs.net

Abstract

Objectives Universally offered child health reviews form the backbone of the UK child health programme. The reviews assess children's health, development and well-being and facilitate access to additional support as required. The number of reviews offered per child has been reduced over recent years to allow more flexible provision of support to families in need: equitable coverage of the remaining reviews is therefore particularly important. This study assessed the coverage of universal child health reviews, with an emphasis on trends over time and inequalities in coverage by deprivation.

Design Assessment of the coverage of child health reviews by area-based deprivation using routinely available data. Supplementary audit of the quality of the routine data source used.

Setting Scotland.

Participants Two cohorts of around 40 000 children each. The cohorts were born in 1998/1999 and 2007/2008 and eligible for the previous programme of five and the current programme of two preschool reviews, respectively.

Outcome measures Coverage of the specified child health reviews for the whole cohorts and by deprivation.

Results Coverage of the 10 day review is high (99%), but it progressively declines for reviews at older ages (86% for the 39–42 month review). Coverage is lower in children living in the most deprived areas for all reviews, and the discrepancy progressively increases for reviews at older ages (78% and 92% coverage for the 39–42 month review in most and least deprived groups). Coverage has been stable over time: it has not increased for the remaining reviews after reduction in the number of reviews provided.

Conclusions The inverse care law continues to operate in relation to ‘universal’ child health reviews. Equitable uptake of reviews is important to ensure maximum likely impact on inequalities in children's outcomes.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2011-000759

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • To cite: Wood R, Stirling A, Nolan C, et al. Trends in the coverage of ‘universal’ child health reviews: observational study using routinely available data. BMJ Open 2012;2:e000759. doi:10.1136/bmjopen-2011-000759

    • Funding RW undertook this work while in receipt of a Clinical Academic Fellowship from the Scottish Government's Chief Scientist Office (CAF/06/05). Study design, conduct and reporting were independent of funders at all times.

    • Competing interests None.

    • Ethics approval Ethical approval was not required for this study. Information Services Division staff adhered to NHS National Services Scotland Confidentiality Guidelines at all times when handling patient data.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The routine data analysed for this study are held by NHS National Services Scotland Information Services Division (http://www.isdscotland.org/).