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Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study

Joanna F Dipnall Orcid Logo, Jane Lyons, Ronan Lyons Orcid Logo, Shanthi Ameratunga, Marianna Brussoni, Frederick P Rivara, Fiona Lecky, Amy Schneeberg, James E Harrison, Belinda Gabbe Orcid Logo

Archives of Disease in Childhood

Swansea University Authors: Jane Lyons, Ronan Lyons Orcid Logo, Belinda Gabbe Orcid Logo

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DOI (Published version): 10.1136/archdischild-2024-327096

Abstract

Objective: To investigate the moderating effects of socio-demographic social determinants of health (SDH) in the relationship between types of childhood hospitalisation (ie, none, injury, non-injury, injury+non-injury) and academic performance. Design, setting and patients: Children residing in Wale...

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Published in: Archives of Disease in Childhood
ISSN: 0003-9888 1468-2044
Published: BMJ Publishing Group Ltd 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa68507
Abstract: Objective: To investigate the moderating effects of socio-demographic social determinants of health (SDH) in the relationship between types of childhood hospitalisation (ie, none, injury, non-injury, injury+non-injury) and academic performance. Design, setting and patients: Children residing in Wales 2009–2016 (N=369 310). Secure Anonymised Information Linkage databank linked Tagged Electronic Cohort Cymru (five data sources) from the Wales Electronic Cohort for Children. Main outcome measure: Binary educational achievement (EA) measured across three key educational stage time points: grade 6 (mean age 11 years, SD 0.3), 9 (mean age 14 years, SD 0.3) and 11 (mean age 16 years, SD 0.3). Results: Of the 369 310 children, 51% were males, 25.4% of children were born in the lowest two Townsend deciles. Females were more likely to meet EA than males (adjusted risk ratio (aRR) (95% CI): 1.047 (1.039, 1.055)). EA was lower for injury admissions in males and any admission type in females (interactions: female×non-injury 0.982 (0.975, 0.989); female×injury+non-injury 0.980 (0.966, 0.994)). Children born into a more deprived decile were less likely to achieve EA (0.979 (0.977, 0.980)) and worsened by an injury admission (interactions: townsend×injury 0.991 (0.988, 0.994); Townsend×injury+non-injury 0.997 (0.994, 1.000)). Children with special educational needs (SEN) were less likely to meet EA (0.471 (0.459, 0.484) especially for an injury admission (interactions: SEN×injury 0.932 (0.892, 0.974)). Conclusion: SDH moderated the impact of hospital admission type on educational outcomes prompting future investigation into the viability of in-hospital routine screening of families for SDH and relevant post-hospital interventions to help reduce the impact of SDH on educational outcomes post-hospitalisation.
College: Faculty of Medicine, Health and Life Sciences
Funders: VIBES-Junior project: National Health and Medical Research Council of Australia (NHMRC-APP1142325); The Wales Electronic Cohort for Children (WECC) study was funded through Health and Care Research Wales (TRP08-006). Professor Lyons is supported by grants Health Data Research UK (HDR-9006) and UKRI-Economic and Social Research Council (ES/W012227/1). Jane Lyons is supported by grants from Health Data Research UK (HDR-9006) and UKRI-Economic and Social Research Council (ES/W012227/1). Professor Gabbe is supported by an NHMRC Investigator Grant (ID 2009998). The other authors received no additional funding.

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