81 Rates and reasons for hospitalization of children and youth with foster home experience: A Pan-Canadian cohort study
Notice bibliographique
Résumé
Abstract Background In Canada, an estimated 4-7% of children will be placed in a foster home during their childhood. First Nations children are 17 times more likely to be removed from their home compared to non-First Nations children due to the ongoing legacy of the Canadian Indian Residential School System, but there are no published data for Métis and Inuit children. Childhood trauma and caregiver disruption is associated with poor health and mental health outcomes, yet little is known about the healthcare use of these children across Canada. Objectives To determine the rates and conditions responsible for hospitalization of children with foster home experience across Canada. Design/Methods This is a cohort study of Canadian children < 18 years of age living in a foster home on the day of the 2011 Census. We determine the rate of hospitalization over 6 years (2011 to 2017) using Statistics Canada’s 2011 Canadian Census Health and Environment Cohorts, which links National Household Survey (NHS) (demographics), and the Discharge Abstract Database (hospitalization encounters). Indigenous status was identified by the respondent of the NHS. Survey weights were applied to render the results representative of the Canadian population. All provinces and territories in Canada except for Quebec were included. The University of Ottawa’s Research Ethics Board approved this study as exempt. Results After survey weights, our study represented 31,595 children in foster homes compared to 5,317,346 children not in foster homes. 50.5 per 1,000 of respondent-identified First Nations children lived in foster homes on the day of the Census compared to 3.3 per 1,000 of non-Indigenous and non-Racialized children (Table 1). Rates of living in foster home per 1,000 was 18.4 for Métis, 25.6 for Inuit, and 5.2 for Black children. Age standardized rates of hospitalization for children with foster home experience was 4.8 per 100 person-years, compared to 2.5 per 100 person-years for those without foster home experience, where hospitalization rates varied by age (Figure 1). 3% of children with foster home experience had 3 or more hospitalizations and were responsible for 49% of all hospitalizations in that population. The top conditions responsible for hospitalization for children with foster home experience were childbirth and mental health. Conclusion Our study, shared with national First Nations, Métis and Inuit agencies, indicate a substantial overrepresentation of First Nations, Métis, Inuit, and Black children in foster homes in Canada. These children face higher rates of youth pregnancies and mental health hospitalizations. As the preliminary data of one of three cohorts, these results indicate that further work is needed to expand collaborations and set research priorities to generate essential evidence on the health of this vulnerable population.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,003 | 0,001 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,002 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».