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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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Method<\/jats:title>\n            <jats:p>Working with stakeholders\u2014in an English region of 2.7m population- we agreed a definition of families having complex needs which would benefit from service integration \u2013 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>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, \u00a3362 million in total, of which 42% was on children in care of local authorities. The households had contact with 3\u20134 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.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>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.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12913-024-12100-x","type":"journal-article","created":{"date-parts":[[2025,1,27]],"date-time":"2025-01-27T13:54:40Z","timestamp":1737986080000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Identifying households with children who have complex needs: a segmentation model for integrated care systems"],"prefix":"10.1186","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1139-2949","authenticated-orcid":false,"given":"Roberta","family":"Piroddi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Astbury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesam","family":"Baker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kostantinos","family":"Daras","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Rafferty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iain","family":"Buchan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Barr","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,27]]},"reference":[{"issue":"384","key":"12100_CR1","doi-asserted-by":"publisher","first-page":"q317","DOI":"10.1136\/bmj.q317","volume":"8","author":"K Abbasi","year":"2024","unstructured":"Abbasi K. 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The secondary analysis of anonymised data provided in a public health activity designed to investigate the health and care issues in a population to improve service development and population health is not classified as research and thus it does not require ethics committee review (see the document produced by the UK NHS Health Research Authority:) and according to the standard defined in Section 251(10) and 251(11) of the National Health Service Act 2006. The project was approved by C&M Health and Care Partnership Combined Intelligence for Population Health Action (CIPHA) Data Access Approval Group (DAAG): (DSR079_DARF). The cohort of patients analysed excluded patients whose primary care practice did not have a data sharing agreement for population health management purposes with C&M NHS Integrated Care Board. The project was approved by the Caldicott Guardian on 17\/08\/21 and by CIPHA DAAG on 05\/10\/21. Data was extracted through CIPHA secure data environment (SDE).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"RP, BB, and KD report no conflict of interest in this project. AA is employed by NHS Cheshire and Merseyside Integrated Care Board, who is the commissioner of health services in Cheshire and Merseyside. WB and IB are employed, and JR was formerly employed by NHS Mersey Care Foundation Trust, which is one of the providers of community and mental health services in Cheshire and Merseyside. AA, WB, and JR were involved in providing information about general service provision in Cheshire and Merseyside, facilitating access to data, as well as providing contextual information for the interpretation of the results, and reviewing drafts of the manuscript. They had no role in the analysis or presentation of the results. The views expressed in this article are those of the authors and do not represent the views of Mersey Care NHS Foundation Trust. There are no other relationships or activities that could appear to have influenced the submitted work.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"152"}}