Dipnall, J.F. orcid.org/0000-0001-7543-0687, Lyons, J., Lyons, R. et al. (7 more authors) (2025) Exploring interaction effects of social determinants of health with hospital admission type on academic performance: a data linkage study. Archives of Disease in Childhood, 110 (3). pp. 228-236. ISSN 0003-9888
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.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 The Authors. Except as otherwise noted, this author-accepted version of a journal article published in Archives of Disease in Childhood is made available via the University of Sheffield Research Publications and Copyright Policy under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 19 Nov 2024 10:03 |
Last Modified: | 11 Mar 2025 10:37 |
Status: | Published |
Publisher: | BMJ |
Refereed: | Yes |
Identification Number: | 10.1136/archdischild-2024-327096 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:219759 |