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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, Shanthi Ameratunga, Marianna Brussoni, Frederick P Rivara, Fiona Lecky, Amy Schneeberg, James E Harrison, Belinda Gabbe Orcid Logo

Archives of Disease in Childhood, Volume: 110, Issue: 3, Pages: 228 - 236

Swansea University Authors: Jane Lyons, Ronan Lyons, 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 2025
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URI: https://cronfa.swan.ac.uk/Record/cronfa68507
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Design, setting and patients: Children residing in Wales 2009&#x2013;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&#xD7;non-injury 0.982 (0.975, 0.989); female&#xD7;injury+non-injury 0.980 (0.966, 0.994)). 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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). 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spelling 2025-02-25T11:52:08.1003824 v2 68507 2024-12-09 Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study 1b74fa5125a88451c52c45bcf20e0b47 Jane Lyons Jane Lyons true false 83efcf2a9dfcf8b55586999d3d152ac6 Ronan Lyons Ronan Lyons true false 4bdcc94332b2bd10530c5e71ceb04f14 0000-0001-7096-7688 Belinda Gabbe Belinda Gabbe true false 2024-12-09 MEDS 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. Journal Article Archives of Disease in Childhood 110 3 228 236 BMJ 0003-9888 1468-2044 1 3 2025 2025-03-01 10.1136/archdischild-2024-327096 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Not Required 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. 2025-02-25T11:52:08.1003824 2024-12-09T15:35:32.6910245 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Joanna F Dipnall 0000-0001-7543-0687 1 Jane Lyons 2 Ronan Lyons 3 Shanthi Ameratunga 4 Marianna Brussoni 5 Frederick P Rivara 6 Fiona Lecky 7 Amy Schneeberg 8 James E Harrison 9 Belinda Gabbe 0000-0001-7096-7688 10 68507__33092__d8d84da8251248ce90547e7c683c41c4.pdf archdischild-2024-327096.pdf 2024-12-09T15:35:32.6833882 Output 212906 application/pdf Accepted Manuscript true © 2024 The Author(s). Author accepted manuscript document released under the terms of a Creative Commons CC-BY licence using the Swansea University Research Publications Policy (rights retention). true eng https://creativecommons.org/licenses/by/4.0/
title Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study
spellingShingle Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study
Jane Lyons
Ronan Lyons
Belinda Gabbe
title_short Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study
title_full Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study
title_fullStr Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study
title_full_unstemmed Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study
title_sort Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study
author_id_str_mv 1b74fa5125a88451c52c45bcf20e0b47
83efcf2a9dfcf8b55586999d3d152ac6
4bdcc94332b2bd10530c5e71ceb04f14
author_id_fullname_str_mv 1b74fa5125a88451c52c45bcf20e0b47_***_Jane Lyons
83efcf2a9dfcf8b55586999d3d152ac6_***_Ronan Lyons
4bdcc94332b2bd10530c5e71ceb04f14_***_Belinda Gabbe
author Jane Lyons
Ronan Lyons
Belinda Gabbe
author2 Joanna F Dipnall
Jane Lyons
Ronan Lyons
Shanthi Ameratunga
Marianna Brussoni
Frederick P Rivara
Fiona Lecky
Amy Schneeberg
James E Harrison
Belinda Gabbe
format Journal article
container_title Archives of Disease in Childhood
container_volume 110
container_issue 3
container_start_page 228
publishDate 2025
institution Swansea University
issn 0003-9888
1468-2044
doi_str_mv 10.1136/archdischild-2024-327096
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
active_str 0
description 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.
published_date 2025-03-01T09:38:54Z
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score 11.059572

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