Background

The responsibility of local authorities in England to provide children in care with stable, local placements has become increasingly difficult due to the rising number of children in need of care and a shortage of available placements. It is unclear if the trend of outsourcing children's social care to private companies has exacerbated this challenge. This paper examines how the outsourcing of children's social care to the private market has influenced placement locality and long-term stability over time.

Methods

We created a novel dataset of multiple administrative data sources on the outsourcing, placement locality and stability, and characteristics of children in care between 2011 and 2022. We conducted time-series fixed-effects regression analysis of the impact of for-profit outsourcing on placement locality and stability from 2011 to 2022.

Results

Our fully adjusted models demonstrate that for-profit outsourcing is consistently associated with more children being placed outside their home local authority and greater placement instability. We found that an increase of 1 % point of for-profit outsourcing was associated with an average increase of 0.10 % points (95 % CI 0.02–0.17; p = 0.01) more children experiencing placement disruption, and 0.23 % points (95 % CI 0.15–0.30; p < 0.001) more children being placed outside their home local authority. We estimate that an additional 17,001 (95 % CI 9015–24,987) out-of-area placements can be attributed to increases in for-profit provision.

Discussion

Our analyses show that placement stability and distance have deteriorated or stagnated over the last decade, and that the local authorities that rely most on outsourcing have the highest rates of placement disruptions and out-of-area placements.

中文翻译：

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2011-2022 年英国营利性外包及其对照护儿童安置稳定性和就地性的影响：纵向生态分析

背景

由于需要照顾的儿童数量不断增加以及可用安置的短缺，英格兰地方当局为受照顾的儿童提供稳定的当地安置的责任变得越来越困难。目前尚不清楚将儿童社会护理外包给私营公司的趋势是否加剧了这一挑战。本文探讨了将儿童社会关怀外包给私人市场如何影响安置地点和长期稳定性。

方法

我们创建了一个包含多个管理数据源的新颖数据集，涉及 2011 年至 2022 年间的外包、安置地点和稳定性以及受照料儿童的特征。我们对营利性外包对安置的影响进行了时间序列固定效应回归分析2011年至2022年的局部性和稳定性。

结果

我们经过全面调整的模型表明，营利性外包始终与更多儿童被安置在地方当局之外以及更大的安置不稳定相关。我们发现，营利性外包每增加 1%， 经历安置中断的儿童数量平均增加 0.10%（95% CI 0.02-0.17； p = 0.01），并且与平均增加 0.23%（95% CI）相关。 0.15–0.30；p  < 0.001) 更多的儿童被安置在当地政府所在地之外。我们估计，额外 17,001 (95% CI 9015–24,987) 的区外安置可归因于营利性拨款的增加。

讨论

我们的分析表明，在过去十年中，安置的稳定性和距离已经恶化或停滞，而且最依赖外包的地方当局的安置中断和区外安置发生率最高。