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Access and utilization patterns of school-based health centers at urban and rural elementary and middle schools.

机译:城乡中小学校本卫生中心的获取和利用模式。

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OBJECTIVE: We examined patterns of enrollment, use, and frequency of use in school-based health centers (SBHCs), as well as the referral, diagnosis, and disposition of SBHC visits among newly implemented SBHCs. METHODS: Four rural and four urban school districts implementing SBHCs were examined from 2000 to 2003. Total school enrollment for students was 13,046. SBHC enrollment and medical encounter data were tracked using a Web-based medical database. Descriptive analyses were conducted to evaluate primary care access and utilization patterns. RESULTS: A total of 7,460 (57.2%) students were enrolled in their SBHCs, of which 4,426 used the SBHC at least once for a total of 14,050 visits. SBHC enrollment was greater in urban districts but rate of utilization was higher in rural districts. Black students, students with public or no health insurance, and students with asthma or attention deficit disorder had higher enrollment and utilization. Rural parents referred more children to SBHCs than urban parents. Teachers referred more students who were black, had asthma, had no public or health insurance, or had acute-type health issues. Total visits increased during the three years, with the largest increase in mental health services. Students who were younger, white, attended rural schools, had public or health insurance, or had infections were more likely to be sent home. Those with chronic conditions and visits for mental health were more likely to be returned to class. CONCLUSION: Utilization patterns suggest improved access to needed health care for disadvantaged children. SBHCs are an important part of the safety net for the populations they are intended to serve.
机译:目的:我们研究了学校卫生中心(SBHC)的入学方式,使用方式和使用频率,以及在新实施的SBHC中转诊,诊断和处置SBHC的方式。方法:从2000年到2003年,对四个实施SBHC的农村和四个城市学区进行了检查。学生的总入学人数为13046。使用基于Web的医疗数据库跟踪了SBHC的入学和就诊数据。进行描述性分析以评估初级保健的获得和利用模式。结果:总共有7,460(57.2%)名学生注册了SBHC,其中4,426名至少使用过SBHC一次,总共访问了14,050次。在城市地区,SBHC的入学率较高,但在农村地区,其利用率较高。黑人学生,有公共医疗保险或没有医疗保险的学生以及患有哮喘或注意力缺陷障碍的学生的入学率和利用率更高。与城市父母相比,农村父母向SBHCs推荐的孩子更多。老师推荐了更多黑人,哮喘,没有公共或健康保险或急性健康问题的学生。在这三年中,总访问量有所增加,其中精神卫生服务的增长最大。年纪较小,白人,在农村学校上学,有公共或健康保险或感染的学生更有可能被送回家。那些患有慢性疾病并有精神健康就诊机会的人更有可能重返课堂。结论:利用方式提示弱势儿童获得所需保健的机会增加。 SBHC对他们打算服务的人群来说是安全网的重要组成部分。

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