Evidence map›Paper›PMID 38991704›Full record

Trial reportBMJ quality & safety2024

Investigating a novel population health management system to increase access to healthcare for children: a nested cross-sectional study within a cluster randomised controlled trial.

Elizabeth Cecil, Julia Forman, James Newham, Nan Hu, Raghu Lingam, Ingrid Wolfe

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in BMJ quality & safety, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03461848 (The Children and Young People's Health Partnership), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03461848 nacompletednot on this map

The Children and Young People's Health Partnership (CYPHP) Evelina London Model of Care: An Opportunistic Cluster Randomised Evaluation to Assess Child Health Outcomes, Healthcare Quality, and Health Service Use.

TypeinterventionalSponsorGuy's and St Thomas' NHS Foundation TrustRan2018 to 2022Enrolled1,731ConditionsAsthma, Eczema, ConstipationArmsCYPHP Evelina London Model of care, Enhanced Usual Care
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Trial
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Elizabeth CecilDepartment of Women's and Children's Health, King's College London, London, UK lizzie.cecil@kcl.ac.uk.ORCID 0000-0002-5281-6656
Julia FormanDepartment of Women's and Children's Health, King's College London, London, UK.
James NewhamNorthumbria University, Newcastle upon Tyne, UK.
Nan HuDepartment of Paediatrics, University of New South Wales, Sydney, New South Wales, Australia.
Raghu LingamDepartment of Paediatrics, University of New South Wales, Sydney, New South Wales, Australia.
Ingrid WolfeDepartment of Women's and Children's Health, King's College London, London, UK.ORCID 0000-0002-4717-7634

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEarly intervention for unmet needs is essential to improve health. Clear inequalities in healthcare use and outcomes exist. The Children and Young People's Health Partnership (CYPHP) model of care uses population health management methods to (1) identify and proactively reach children with asthma, eczema and constipation (tracer conditions); (2) engage these families, with CYPHP, by sending invitations to complete an online biopsychosocial Healthcheck Questionnaire; and (3) offer early intervention care to those children found to have unmet health needs. We aimed to understand this model's effectiveness to improve equitable access to care.

methodsWe used primary care and CYPHP service-linked records and applied the same methods as the CYPHP's population health management process to identify children aged <16 years with a tracer condition between 1 April 2018 and 30 August 2020, those who engaged by completing a Healthcheck and those who received early intervention care. We applied multiple imputation with multilevel logistic regression, clustered by general practitioner (GP) practice, to investigate the association of deprivation and ethnicity, with children's engagement and receiving care.

resultsAmong 129 412 children, registered with 70 GP practices, 15% (19 773) had a tracer condition and 24% (4719) engaged with CYPHP's population health management system. Children in the most deprived, compared with least deprived communities, had 26% lower odds of engagement (OR 0.74; 95% CI 0.62 to 0.87). Children of Asian or black ethnicity had 31% lower odds of engaging, compared with white children (0.69 (0.59 to 0.81) and 0.69 (0.62 to 0.76), respectively). However, once engaged with the population health management system, black children had 43% higher odds of receiving care, compared with white children (1.43 (1.15 to 1.78)), and children from the most compared with least deprived communities had 50% higher odds of receiving care (1.50 (1.01 to 2.22)).

conclusionDetection of unmet needs is possible using population health management methods and increases access to care for children from priority populations with the highest needs. Further health system strengthening is needed to improve engagement and enhance proportionate universalist access to healthcare. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov Registry (NCT03461848).

Indexed as

Health Services AccessibilityPopulation Health ManagementAdolescentChildChild Health ServicesChild, PreschoolCross-Sectional StudiesFemaleHumansInfantMalePrimary Health CareHealthcare quality improvementHealth services researchPaediatrics

Identifiers

PMID38991704
PMCPMC11503201

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.