Objective: To describe the quantity and type of school health services provide d by nurses in Boston Public Schools. Setting: In 2001, the 63024 students enrol led predominantly belonged to minority groups (48%black, 28%Hispanic, and 9%A sian)-and were eligible for a free or reduced-price lunch (71%). Main Outcome Measure: Analysis of the 2001-2002 Boston Public Schools Health Services datab ase. Results: A total of 63 024 students generated 721291 individual encounters with 93.5 full-time equivalent school nurses, including episodic care (57.8% ), medication administration (31.5%), procedures (6.2%), and screening (5.1 %). A total of 2420 students had an individual health care plan for the adminis tration of medications and procedures during the school day. Students with indiv idual health care plans averaged 117.9 encounters per year with school nurses, and students without averaged 7.2 encounters per year. Outcomes of encounters i ncluded school dismissal (3.0%); verbal communication with parents (10.6%), school staff (3.9%), and community agencies or health care providers (1.1%); and referral to a primary care provider (4.6%) or emergency services ( < 0.1 %). Conclusions: Some school-age children receive a large amount of health car e from school nurses in Boston Public Schools. We estimate that these children a re 8 times more likely to see a school nurse than a pediatric health care provid er. These school nurses were involved in the care of children with mental health and chronic he alth care needs. Despite the extensive amount of care, little is known about the efficacy of the care provided or the effect of these services on health care us e.
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