This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (34)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Adolescent Medicine  • Alert me on articles by topic  Social Bookmarking   What's this?

Use of Health Services

David W. Kaplan, MD, MPH; B. Ned Calonge, MD, MPH; Bruce P. Guernsey, MSW; Maureen B. Hanrahan, BSN, MA

Arch Pediatr Adolesc Med. 1998;152:25-33.

Objective  To explore the use of physical and mental health services for adolescents who are enrolled in managed care and have access to a school-based health center (SBHC), compared with adolescents enrolled in managed care without access to an SBHC.

Design  Retrospective cohort designed with age, sex, and socioeconomic status matching to compare the use of health services for adolescent members of Kaiser Permanente of Colorado (who had access to SBHCs) with those with no access.

Participants  The study included 342 adolescents, resulting in 3394 visits that occurred during 3 academic years. During the study, 240 adolescents with access to an SBHC were compared with 116 adolescents without access to an SBHC.

Main Outcome Measures  The use of primary and subspecialty medical, mental health, and substance abuse treatment services; the use of after-hours (emergent or urgent) care; and comprehensive preventive health supervision visits and documentation of screening for high-risk health behaviors.

Results  Adolescents with access to SBHCs were more than 10 times more likely to make a mental health or substance abuse visit (98% of these visits were made at the SBHC) (P<.001). Adolescents with SBHC access had an after-hours (emergent or urgent) care visit rate of 0.33 to 0.52 visits per year less (38%-55% fewer visits) than adolescents without SBHC access, and, overall, made almost 1 additional medical visit per year. A greater percentage, 80.2%, of adolescents with access to SBHCs had at least 1 comprehensive health supervision visit compared with 68.8% of adolescents without access (P=.04). In addition, the adolescents with access were screened for high-risk behaviors at a higher rate.

Conclusions  School-based health centers seem to have a synergistic effect for adolescents enrolled in managed care in providing comprehensive health supervision and primary health and mental health care and in reducing after-hours (emergent or urgent) visits. School-based health centers are particularly successful in improving access to and treatment for mental health problems and substance abuse.

From the University of Colorado School of Medicine, Denver (Dr Kaplan); Kaiser Permanente of Colorado, Denver (Dr Calonge and Ms Hanrahan); and the Colorado Department of Public Health and Environment, Denver (Mr Guernsey).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

School-Based Health Centers: Improving Access and Quality of Care for Low-Income Adolescents
Allison et al.
Pediatrics 2007;120:e887-e894.
ABSTRACT | FULL TEXT  

School-Based Health Centers and the Decline in Black Teen Fertility During the 1990s in Denver, Colorado
Ricketts and Guernsey
AJPH 2006;96:1588-1592.
ABSTRACT | FULL TEXT  

School Nursing Services: Use in an Urban Public School System
Schainker et al.
Arch Pediatr Adolesc Med 2005;159:83-87.
ABSTRACT | FULL TEXT  

School-Based Mental Health Services
Committee on School Health
Pediatrics 2004;113:1839-1845.
ABSTRACT | FULL TEXT  

Reduced School Dropout Rates Among Adolescent Mothers Receiving School-Based Prenatal Care
Barnet et al.
Arch Pediatr Adolesc Med 2004;158:262-268.
ABSTRACT | FULL TEXT  

Missed Opportunities for Sexually Transmitted Diseases, Human Immunodeficiency Virus, and Pregnancy Prevention Services During Adolescent Health Supervision Visits
Burstein et al.
Pediatrics 2003;111:996-1001.
ABSTRACT | FULL TEXT  

Police Reporting and Professional Help Seeking for Child Crime Victims: A Review
Finkelhor et al.
Child Maltreat 2001;6:17-30.
ABSTRACT  

A Comparison Study of an Elementary School-Based Health Center: Effects on Health Care Access and Use
Kaplan et al.
Arch Pediatr Adolesc Med 1999;153:235-243.
ABSTRACT | FULL TEXT  

Elementary School-based Health Center Use
Kaplan et al.
Pediatrics 1998;101 :e12-e12.
ABSTRACT | FULL TEXT