School-based adolescent health care. Review of a clinical service
M. Fisher, L. Juszczak, S. B. Friedman, M. Schneider and G. Chapar
Department of Pediatrics, North Shore University Hospital-Cornell University Medical College, Manhasset, NY 11030.
OBJECTIVE--To provide recommendations regarding the establishment and
maintenance of school-based clinics, based on analysis of data from a
clinic located in a New York City high school. DESIGN--Review of
demographic, medical, and psychosocial data collected during student
visits. SUBJECTS--During 2 1/2 years, 1283 students were seen. The students
were 53% girls and 47% boys; 65% black and 25% Hispanic; and 65% grades
9-10 and 35% grades 11-12. RESULTS--There were 7920 visits. Visits were for
acute or chronic medical problems (44%), physical examinations and
immunizations (25%), gynecologic or sexuality-related issues (17%), and
mental health concerns (14%). Psychosocial characteristics of the 378
students who enrolled during the 1989-1990 academic year indicated that
only 27% lived with both natural parents, 55% were foreign-born, 37% had
repeated a grade at least once, 44% were sexually active, 13% drank
alcohol, and 14% had past or present suicidal ideation. CONCLUSIONS--These
data demonstrate that a school-based clinic can be involved in the
management of a wide range of health care needs for large numbers of
at-risk youth. In addition, school-based clinics can serve as a major site
for the teaching of medical students and residents, and as a valuable
resource for clinical research.
