ORIGINAL ARTICLE Health needs of regional Australian children in out-of-home care Nitin Arora, 1 Melissa Kaltner 2 and Judy Williams 3 1 Department of Family & Community Services, New South Wales, 2 Darling Downs Health Service and 3 Bundaberg Base Hospital, Queensland Health, Brisbane, Queensland, Australia Aim: This study aims to identify the health needs of children placed in out-of-home care in regional Queensland and to compare them with the needs of similar children in metropolitan Queensland. Methods: Retrospective chart review and subsequent analysis of data from the first assessments of the children placed in care from January 2005 to April 2011. Health needs based on assessment recommendations were then compared with needs and recommendations from a similar clinic in metropolitan Brisbane. Results: Two hundred thirty-nine first assessments were reviewed. The average number of health referrals arising out of each assessment was 2. 72% children were between 2 and 12 years of age and accounted for 76% of the health referrals made. The 10–13% of the children needed referrals for medical and surgical specialties, audiology, speech pathology, dental, and ophthalmology/optometry, each. A percentage of 30 needed ongoing paediatric care. The 15% needed immunisation catch up, 35% counselling and behaviour management, and 15% formal mental health referrals. These were comparable to the health needs identified in out-of-home care children residing in metropolitan Queensland. Conclusion: Children in care who live in a regional setting have similar health-care needs compared with urban children. Given restricted health services in regional settings, there is difficulty in accessing services to meet these needs. Key words: child; foster care; health; out-of-home care; rural. What is already known on this topic 1. Children in care exhibit much higher rates of physical and emo- tional pathology including physical disability, behavioural prob- lems, developmental delays, immunisation delays and mental health disorders. What this paper adds 1. Children in care in regional settings have similar increased health requirements compared with children in urban settings and may be further disadvantaged due to lack of service access in regional areas. There is abundant international data 1,2 and emerging literature from Australia 3,4 that suggests that children in out-of-home care (OOHC) exhibit high rates of health need comparative to the general child population. The number of children subject to care and under protection orders in Australia continues to climb, with a 57% increase between the periods of 2005–2010 alone. 5 Given that legal guardianship of children residing in OOHC is granted to the State, there is a need to ensure that health needs of this population are appropriately identified and met. To this end, Child Health Passport Clinics have been established in some locations in Australia to provide comprehensive health assessment to all children placed in OOHC. Although two recent studies focused on such clinics have quantified health need for samples of Australian children in OOHC, both studies were limited to modestly sized samples of children residing only in metropolitan areas. 3,4 Further research is required to more broadly conceptualise the health needs of Australian Children in OOHC, particularly for those residing in regional and rural locations. Study aims This study aims to add to the existing knowledge about the health needs of children in OOHC by analysing data relating to a large sample of children assessed at a Child Health Passport Clinic located at the regional Queensland setting of Bundaberg Hospital in order to: 1 Identify the health needs of children placed in OOHC in a regional Australian setting. 2 Assess variation in the health needs in different developmen- tal age groups. 3 Compare the health needs of the children placed in OOHC in this regional sample with health needs identified in children in OOHC placed in a metropolitan Queensland setting. 3 4 Examine the burden of the health need in relation to the availability of health services. Methods Setting The study comprised a retrospective chart review of the data obtained during the initial assessment of children attending the Correspondence: Dr Melissa Kaltner, Department of Family and Commu- nity Services, Level 1, 2 Cavill Ave, Ashfield, NSW 2131, Australia. Fax: 02 9716 2983 ; email: melissa.kaltner@facs.nsw.gov.au Conflict of interest: None declared. Accepted fot publication 28 March 2014. doi:10.1111/jpc.12637 Journal of Paediatrics and Child Health 50 (2014) 782–786 © 2014 The Authors Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians). 782