{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T05:47:13Z","timestamp":1747201633105,"version":"3.40.5"},"reference-count":54,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Health Data Research UK","award":["MR\/S003800\/1"],"award-info":[{"award-number":["MR\/S003800\/1"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nBackground<\/jats:title>\nTo compare health, educational and employment outcomes of schoolchildren receiving medication for a skin disorder with peers.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nThis retrospective population cohort study linked eight Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, school examinations, school absences\/exclusions and unemployment to investigate educational (absence, exclusion, special educational need, academic attainment), employment, and health (admissions and mortality) outcomes of 766,244 children attending local authority run primary, secondary and special schools in Scotland between 2009 and 2013.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nAfter adjusting for sociodemographic and maternity confounders the 130,087 (17.0%) children treated for a skin disorder had increased hospitalisation, particularly within one year of commencing treatment (IRR 1.38, 95% CI 1.35\u20131.41, p<0.001) and mortality (HR 1.50, 95% CI 1.18\u20131.90, p<0.001). They had greater special educational need (OR 1.19, 95% CI 1.17\u20131.21, p<0.001) and more frequent absences from school (IRR 1.07, 95% CI 1.06\u20131.08, p<0.001) but did not exhibit poorer exam attainment or increased post-school unemployment. The associations remained after further adjustment for comorbid chronic conditions.<\/jats:p>\n<\/jats:sec>\n\nConclusions<\/jats:title>\nDespite increased hospitalisation, school absenteeism, and special educational need, children treated for a skin disorder did not have poorer exam attainment or employment outcomes. Whilst findings relating to educational and employment outcomes are reassuring, the association with increased risk of mortality is alarming and merits further investigation.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0243383","type":"journal-article","created":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T19:17:32Z","timestamp":1607714252000},"page":"e0243383","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Health, educational and employment outcomes among children treated for a skin disorder: Scotland-wide retrospective record linkage cohort study of 766,244 children"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2185-4502","authenticated-orcid":true,"given":"Michael","family":"Fleming","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James S.","family":"McLay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Clark","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albert","family":"King","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel F.","family":"Mackay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill P.","family":"Pell","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"issue":"5","key":"pone.0243383.ref001","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1001\/jamadermatol.2016.5538","article-title":"Global Skin Disease Morbidity and Mortality: An Update From the Global Burden of Disease Study 2013","volume":"153","author":"C Karimkhani","year":"2017","journal-title":"JAMA Dermatol"},{"issue":"4","key":"pone.0243383.ref002","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1111\/bjd.14361","article-title":"Quality of life impact of childhood skin conditions measured using the Children's Dermatology Life Quality Index (CDLQI): a meta-analysis","volume":"174","author":"JR Olsen","year":"2016","journal-title":"Br J Dermatol"},{"issue":"5","key":"pone.0243383.ref003","doi-asserted-by":"crossref","first-page":"555","DOI":"10.2340\/00015555-2600","article-title":"Health-related Quality of Life in Children and Adolescents with Psoriasis: A Systematic Review and Meta-analysis","volume":"97","author":"H Randa","year":"2017","journal-title":"Acta Derm Venereol"},{"issue":"2","key":"pone.0243383.ref004","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2165\/00019053-200321020-00003","article-title":"Cost of illness of atopic dermatitis in children: a societal perspective","volume":"21","author":"AS Kemp","year":"2003","journal-title":"Pharmacoeconomics"},{"issue":"1","key":"pone.0243383.ref005","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1525-1470.2007.00572.x","article-title":"The socioeconomic impact of atopic dermatitis in the United States: a systematic review","volume":"25","author":"AJ Mancini","year":"2008","journal-title":"Pediatr Dermatol"},{"issue":"4","key":"pone.0243383.ref006","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1046\/j.1365-2133.2002.04964.x","article-title":"The cost of atopic dermatitis in the Netherlands: an international comparison","volume":"147","author":"P Verboom","year":"2002","journal-title":"Br J Dermatol"},{"issue":"1","key":"pone.0243383.ref007","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jid.2016.07.012","article-title":"The burden of atopic dermatitis: Summary of a report for the national eczema association","volume":"137","author":"AM Drucker","year":"2017","journal-title":"J Invest Dermatol"},{"issue":"6","key":"pone.0243383.ref008","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1001\/jamadermatol.2014.3593","article-title":"Economic Burden of Psoriasis in the United States: A Systematic Review","volume":"151","author":"EA Brezinski","year":"2015","journal-title":"JAMA Dermatol"},{"key":"pone.0243383.ref009","unstructured":"Scottish Public Health Observatory (ScotPHO). 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