The Impact of Health and Social Care Integration on Children and Young People's Outcomes: What Can Be Determined from Scotland's Administrative Data?

Introduction: The integration of services is often driven by the belief that integration will lead to better outcomes for service users. However, there is a paucity of robust evidence exploring the relationship between integration and outcomes. This study sought to determine whether the integration of health and social care services via Health and Social Care Partnerships has led to a measurable change in outcomes for Scotland's children and young people. Methods: Multilevel models were applied to routinely collected administrative data to determine whether different approaches to structural integration were related to changes in a range of outcomes for children and young people. The modelling approach accounted for confounding factors such as economic conditions and the COVID-19 pandemic. Results: The analysis found no consistent evidence of an association between the structural integration of services and changes in outcomes for children and young people. However, external factors such as deprivation and the COVID-19 pandemic were found to be linked to changes in outcomes across various areas of children's lives. Conclusions: The findings highlight the complexity in attributing changes in outcomes to a specific intervention or reform, particularly in the presence of wider socio-economic factors. Understanding the influence of systems-level change may not be fully possible using routinely collected data alone, and any methods used to assess impact should be underpinned by an underlying theory of change.