Connecting Healthcare with Income Maximisation Services: A Systematic Review on the Health, Wellbeing and Financial Impacts for Families with Young Children
Burley, Jade
Samir, Nora
Price, Anna
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Parker, Anneka
Zhu, Anna
Eapen, Valsamma
Contreras-Suarez, Diana
Schreurs, Natalie
Lawson, Kenny
Lingam, Raghu
Grace, Rebekah
Raman, Shanti
Kemp, Lynn
Bishop, Rebecca
Goldfeld, Sharon
Woolfenden, Susan
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Woolfenden, S (通讯作者)，Univ NSW, Sch Women & Childrens Hlth, Populat Child Hlth Res Grp, Randwick, NSW 2031, Australia.;Woolfenden, S (通讯作者)，Ingham Inst Appl Med Res, BestSTART SWS, Liverpool, NSW 2170, Australia.;Woolfenden, S (通讯作者)，Sydney Local Hlth Dist, Sydney Inst Women Children & Their Families, Sydney, NSW 2050, Australia.
Financial counselling and income-maximisation services have the potential to reduce financial hardship and its associated burdens on health and wellbeing in High Income Countries. However, referrals to financial counselling services are not systematically integrated into existing health service platforms, thus limiting our ability to identify and link families who might be experiencing financial hardship. Review evidence on this is scarce. The purpose of this study is to review healthcare-income maximisation models of care in high-income countries for families of children aged between 0 and 5 years experiencing financial difficulties, and their impacts on family finances and the health and wellbeing of parent(s)/caregiver(s) or children. A systematic review of the MEDLINE, EMBase, PsycInfo, CINAHL, ProQuest, Family & Society Studies Worldwide, Cochrane Library, and Informit Online databases was conducted according to the Preferred Reporting Items for Systemic Reviews and Meta-Analyses (PRISMA) statement. A total of six studies (five unique samples) met inclusion criteria, which reported a total of 11,603 families exposed to a healthcare-income maximisation model. An average annual gain per person of 1661 pound and 1919 pound was reported in two studies reporting one Scottish before-after study, whereby health visitors/midwives referred 4805 clients to money advice services. In another UK before-after study, financial counsellors were attached to urban primary healthcare centres and reported an average annual gain per person of 1058 pound. The randomized controlled trial included in the review reported no evidence of impacts on financial or non-financial outcomes, or maternal health outcomes, but did observe small to moderate effects on child health and well-being. Small to moderate benefits were seen in areas relating to child health, preschool education, parenting, child abuse, and early behavioral adjustment. There was a high level of bias in most studies, and insufficient evidence to evaluate the effectiveness of healthcare-income maximisation models of care. Rigorous (RCT-level) studies with clear evaluations are needed to assess efficacy and effectiveness.
