ERIC Number: EJ1092379
Record Type: Journal
Publication Date: 2016-Apr
Abstractor: As Provided
Reference Count: N/A
Opening School-Based Health Centers in a Rural Setting: Effects on Emergency Department Use
Schwartz, Katherine E.; Monie, Daphne; Scribani, Melissa B.; Krupa, Nicole L.; Jenkins, Paul; Leinhart, August; Kjolhede, Chris L.
Journal of School Health, v86 n4 p242-249 Apr 2016
Background: Previous studies of urban school-based health centers (SBHCs) have shown that SBHCs decrease emergency department (ED) utilization. This study seeks to evaluate the effect of SBHCs on ED utilization in a rural setting. Methods: This retrospective, controlled, quasi-experimental study used an ED patient data set from the Bassett Healthcare Network in rural New York to compare ED visits between school-aged children from 12 SBHC schools before and after the SBHC opening. Time series analysis was used to determine trends in SBHC schools and 2 control schools without SBHCs over the 18-year study period. Results: ED visit incidence densities for all 12 school districts combined showed a significant increase in ED visits post-SBHC (Rate ratio (RR) = 1.15; p < 0.0001). This increase may, in part, be explained by the upward trend of ED visits in the region, as seen in the small, but significant, positive slope (RR = 0.0033, p < 0.0001) for control schools. There was variation in the change in incidence density post-SBHC among school districts, with increases in 78% of schools. Conclusions: The opening of SBHCs in rural settings results in a slight, but significant, increase in ED use, which is contrary to previous cross-sectional studies in urban settings.
Descriptors: School Health Services, Rural Schools, Program Effectiveness, Hospitals, Quasiexperimental Design, Comparative Analysis, School Districts, Access to Health Care
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Publication Type: Journal Articles; Reports - Research
Education Level: N/A
Authoring Institution: N/A
Identifiers - Location: New York