Identifying households with children who have complex needs: a segmentation model for integrated care systems
Abstract Background Adversity in childhood is increasing in the United Kingdom. Complex health and social problems affecting children cluster in families where adults also have high need, but services are rarely aligned to support the whole family. Household level segmentation can help identify hous...
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BMC
2025-01-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-024-12100-x |
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| author | Roberta Piroddi Andrea Astbury Wesam Baker Kostantinos Daras Joe Rafferty Iain Buchan Benjamin Barr |
| author_facet | Roberta Piroddi Andrea Astbury Wesam Baker Kostantinos Daras Joe Rafferty Iain Buchan Benjamin Barr |
| author_sort | Roberta Piroddi |
| collection | DOAJ |
| description | Abstract Background Adversity in childhood is increasing in the United Kingdom. Complex health and social problems affecting children cluster in families where adults also have high need, but services are rarely aligned to support the whole family. Household level segmentation can help identify households most needing integrated support. Thus, the aim was to develop a segmentation model to identify those households with children who have high levels of complex cross-sectoral needs, to use as a case-finding tool for health and social care services, and to describe characteristics of identified households, to inform service integration. Method Working with stakeholders—in an English region of 2.7m population- we agreed a definition of families having complex needs which would benefit from service integration – including households with high intensity use, who had both physical and mental health problems amongst both adults and children and wider social risks. We then used individual and household linked data across multiple health and social care services to identify these households, providing an algorithm to be used in a case finding interface. Finally, to understand the needs of this segment, and to identify unmet need, to tailor support, we used descriptive statistics and Poisson regression to profile the segment and compare them with the rest of the population. Results Twenty one thousand and five hundreds twenty seven households (8% of the population of the region) were identified with complex needs, including 89,631 people (41,382 children), accounting for 34% of health and social care costs for families with children, £362 million in total, of which 42% was on children in care of local authorities. The households had contact with 3–4 different services, had high prevalence of mental health problems, most frequently co-morbid with respiratory problems, with high mental health emergency service use particularly amongst teenage girls many of whom had no prior elective treatment for conditions. Conclusion Our model provides a potentially useful tool for identifying households that could benefit from better integration of services and targeted family support that can help break intergenerational transfer of adversity. |
| format | Article |
| id | doaj-art-6a90277384c64548a5ebcde8adc3ed14 |
| institution | Kabale University |
| issn | 1472-6963 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj-art-6a90277384c64548a5ebcde8adc3ed142025-02-02T12:14:23ZengBMCBMC Health Services Research1472-69632025-01-0125111210.1186/s12913-024-12100-xIdentifying households with children who have complex needs: a segmentation model for integrated care systemsRoberta Piroddi0Andrea Astbury1Wesam Baker2Kostantinos Daras3Joe Rafferty4Iain Buchan5Benjamin Barr6Department of Public Health Policy and Systems, University of LiverpoolNHS Cheshire and Merseyside Integrated Care BoardNHS Mersey Care Foundation Trust, Kings Business ParkDepartment of Public Health Policy and Systems, University of LiverpoolNHS Mersey Care Foundation Trust, Kings Business ParkDepartment of Public Health Policy and Systems, University of LiverpoolDepartment of Public Health Policy and Systems, University of LiverpoolAbstract Background Adversity in childhood is increasing in the United Kingdom. Complex health and social problems affecting children cluster in families where adults also have high need, but services are rarely aligned to support the whole family. Household level segmentation can help identify households most needing integrated support. Thus, the aim was to develop a segmentation model to identify those households with children who have high levels of complex cross-sectoral needs, to use as a case-finding tool for health and social care services, and to describe characteristics of identified households, to inform service integration. Method Working with stakeholders—in an English region of 2.7m population- we agreed a definition of families having complex needs which would benefit from service integration – including households with high intensity use, who had both physical and mental health problems amongst both adults and children and wider social risks. We then used individual and household linked data across multiple health and social care services to identify these households, providing an algorithm to be used in a case finding interface. Finally, to understand the needs of this segment, and to identify unmet need, to tailor support, we used descriptive statistics and Poisson regression to profile the segment and compare them with the rest of the population. Results Twenty one thousand and five hundreds twenty seven households (8% of the population of the region) were identified with complex needs, including 89,631 people (41,382 children), accounting for 34% of health and social care costs for families with children, £362 million in total, of which 42% was on children in care of local authorities. The households had contact with 3–4 different services, had high prevalence of mental health problems, most frequently co-morbid with respiratory problems, with high mental health emergency service use particularly amongst teenage girls many of whom had no prior elective treatment for conditions. Conclusion Our model provides a potentially useful tool for identifying households that could benefit from better integration of services and targeted family support that can help break intergenerational transfer of adversity.https://doi.org/10.1186/s12913-024-12100-xHealth service innovationPopulation health managementHealth needs segmentationIntegrated health and social care systems |
| spellingShingle | Roberta Piroddi Andrea Astbury Wesam Baker Kostantinos Daras Joe Rafferty Iain Buchan Benjamin Barr Identifying households with children who have complex needs: a segmentation model for integrated care systems BMC Health Services Research Health service innovation Population health management Health needs segmentation Integrated health and social care systems |
| title | Identifying households with children who have complex needs: a segmentation model for integrated care systems |
| title_full | Identifying households with children who have complex needs: a segmentation model for integrated care systems |
| title_fullStr | Identifying households with children who have complex needs: a segmentation model for integrated care systems |
| title_full_unstemmed | Identifying households with children who have complex needs: a segmentation model for integrated care systems |
| title_short | Identifying households with children who have complex needs: a segmentation model for integrated care systems |
| title_sort | identifying households with children who have complex needs a segmentation model for integrated care systems |
| topic | Health service innovation Population health management Health needs segmentation Integrated health and social care systems |
| url | https://doi.org/10.1186/s12913-024-12100-x |
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