title: Factors associated with re-entry to out-of-home care among children in England.
abstract: Exiting and re-entering out-of-home care (OHC) is considered a disruption to permanence which may have long-lasting, negative consequences for children due to a lack of stability and continuity. Each year approximately one-third of children in OHC in England exit, but information is lacking on rates of re-entries and associated factors. Using national administrative data, we calculated rates of re-entry among children exiting OHC from 2007 to 2012, identified key child and care factors associated with re-entry using Cox proportional hazards modelling, and developed a simple probability calculator to estimate which groups of children are most likely to re-enter OHC within three months. Between 2007 and 2012 re-entries to OHC in England decreased (from 23.3% to 14.4% within one year of exit, p<0.001), possibly due to concurrent changes in the way children exited OHC. Overall, more than one-third of children exiting OHC in 2008 re-entered within five years (35.3%, N=4076), but rates of re-entry varied by child and care characteristics including age, ethnicity, mode of exit, and placement stability. Based on these associated factors, we developed a calculator that can estimate the likelihood of rapid re-entry to OHC for a group of children and could be used by social care practitioners or service planners. Our findings provide insight into which groups of children are most likely to re-enter OHC, who may benefit from additional support or ongoing monitoring.
authors.affiliation: Administrative Data Research Centre for England, University College London, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK. Electronic address: louise.mc-grath-lone.13@ucl.ac.uk.
authors.forename: Louise
authors.initials: L
authors.lastname: Mc Grath-Lone
authors.affiliation: Administrative Data Research Centre for England, University College London, London, UK; UCL Institute of Education, University College London, London, UK.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Dearden
authors.affiliation: Department of Health Service Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Katie
authors.initials: K
authors.lastname: Harron
authors.affiliation: Administrative Data Research Centre for England, University College London, London, UK; UCL Institute of Education, University College London, London, UK.
authors.forename: Bilal
authors.initials: B
authors.lastname: Nasim
authors.affiliation: Administrative Data Research Centre for England, University College London, London, UK; UCL Great Ormond Street Institute of Child Health, University College London, London, UK.
authors.forename: Ruth
authors.initials: R
authors.lastname: Gilbert
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004739:England; D005260:Female; D005581:Foster Home Care / Q000523:psychology* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D012008:Recurrence; D012307:Risk Factors; D012944:Social Support
keywords: Looked after children; Out-of-home care; Permanence; Re-entry