Foster and kinship carer survey: Accessing health services for children in out-of-home care

Aim To explore the experiences of Victorian foster and kinship carers in accessing health services for children in their care and to quantify the frequency of potential barriers to health care. Methods On-line survey co-designed with the Foster Care Association of Victoria measuring carer-reported health service engagement by a child/young person in their care, ease of service access, time to receiving Medicare number and out-of-pocket health-related costs. A total of 239 foster and 51 kinship carers were recruited through email and social media by carer support agencies. Results Totally 90% of children/young people had engaged with a general practitioner. Most had engaged with dental (75%), paediatric (72%), optometry (61%) and audiology (54%) services. Mental health services were most likely to be needed but not yet received. Neither carer education nor socio-economic status was associated with likelihood of service engagement. Carers reported that it was hardest to get appointments with mental health and paediatric services. Twenty-seven percent had waited to see a health service because of delays in carers receiving their Medicare number. Sixty percent of carers had paid out-of-pocket for health services; 78% of these had not been reimbursed. Conclusion Victorian foster and kinship carers report high health service use for children and young people in their care. Mental health services were the hardest to access with the largest gap between identified need and service use. Timely access to Medicare numbers and financial support are barriers to access that could be addressed. The development of integrated paediatric health care and clinicians co-located with child protection could also assist.