Article Text

Download PDFPDF

What is the timeliness and extent of health service use of Victorian (Australia) children in the year after entry to out-of-home care? Protocol for a retrospective cohort study using linked administrative data
  1. Karen McLean1,2,3,
  2. Harriet Hiscock2,3,4,5,
  3. Dorothy Scott6,
  4. Sharon Goldfeld1,2,3
  1. 1 Policy and Equity, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
  2. 2 Centre for Community Child Health, Royal Children’s Hospital, Parkville, Victoria, Australia
  3. 3 Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
  4. 4 Health Services, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
  5. 5 Health Services Research Unit, Royal Children’s Hospital, Parkville, Victoria, Australia
  6. 6 Department of Social Work, Health Sciences, University of Melbourne, Parkville, Victoria, Australia
  1. Correspondence to Dr Karen McLean; karen.mclean{at}


Introduction Children entering out-of-home care have high rates of health needs across all domains of health. To identify these needs early and optimise long-term outcomes, routine health assessment on entry to care is recommended by child health experts and included in policy in many jurisdictions. If effective, this ought to lead to high rates of health service use as needs are addressed. Victoria (Australia) has no state-wide approach to deliver routine health assessments and no data to describe the timing and use of health service visits for children in out-of-home care. This retrospective cohort data linkage study aims to describe the extent and timeliness of health service use by Victorian children (aged 0–12 years) who entered out-of-home care for the first time between 1 April 2010 and 31 December 2015, in the first 12 months of care.

Methods and analysis The sample will be identified in the Victorian Child Protection database. Child and placement variables will be extracted. Linked health databases will provide additional data: six state databases that collate data about hospital admissions, emergency department presentations and attendances at dental, mental and community health services and public hospital outpatients. The federal Medicare Benefits Schedule claims dataset will provide information on visits to general practitioners, specialist physicians (including paediatricians), optometrists, audiologists and dentists. The number, type and timing of visits to different health services will be determined and benchmarked to national standards. Multivariable logistic regression will examine the effects of child and system variables on the odds of timely health visits, and proportional-hazards regression will explore the effects on time to first health visits.

Ethics and dissemination Ethical and data custodian approval has been obtained for this study. Dissemination will include presentation of findings to policy and service stakeholders in addition to scientific papers.

  • comm child health
  • health services research
  • paediatric practice

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Patient consent for publication Not required.

  • Contributors KM led the writing of this paper. All authors contributed to the design of the study and the writing of this paper, and approved the final draft.

  • Funding This research is supported by a Learning System Grant from the Centre for Excellence in Child and Family Welfare, the Child Health and Wellbeing Unit, Department of Health and Human Services, Victoria and the Victorian Government’s Operational Infrastructure Support Program. KM is supported by an Australian Government Research Training Program Scholarship PhD scholarship and Murdoch Children’s Research Institute scholarship. SG is supported by Australian National Health and Medical Research Council (NHMRC) Career Development Fellowship 1082922. HH is supported by Australian National Health and Medical Research Council (NHMRC) Career Development Fellowship 1136222.

  • Competing interests Not required.

  • Ethics approval Ethics approval has been granted by the Royal Children’s Hospital Melbourne Human Research Ethics Committee (HREC no. 37208A, 24 October 2017) and the Australian Institute of Health and Welfare Ethics Committee (EO2017/5/405, 5 December 2017). Approval has been granted by the Data Custodian in Victoria and a public interest certificate signed for the MBS billing data.

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

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.