Organisational models of health services for children and adolescents in out‐of‐home care: health technology assessment

T Mensah, A Hjern, K Håkanson, P Johansson, A K Jonsson, T Mattsson, S Tranæus, B Vinnerljung, P Östlund, G Klingberg - Acta Paediatrica



Decades of research confirm that children and adolescents in out‐of‐home care (foster family, residential care) have much greater healthcare needs than their peers. A systematic literature review was conducted to evaluate organizational healthcare models for this vulnerable group.


A systematic literature search was undertaken of the following databases: Academic Search Elite, CENTRAL, Cochrane Database of Systematic Reviews, Cinahl, DARE, ERIC, HTA, PsycInfo, Psychology and Behavioural Sciences Collection, PubMed, SocIndex. Randomized and non‐randomized controlled trials were to be included. Two pairs of reviewers independently assessed abstracts of the identified published papers. Abstracts meeting the inclusion criteria were ordered in full text. Each article was reviewed independently, by pairs of reviewers. A joint assessment was made based on the inclusion criteria and relevance. Cases of disagreement were resolved by consensus discussion.


No study with low or medium risk of bias was identified.


In the absence of studies of acceptable quality, it is not possible to assess the impact of organizational models intended to ensure adequate health and dental care for children and adolescents in out‐of‐home care. Therefore, well‐designed follow‐up studies should be conducted following the implementation of such models.