Health At School: A Hidden Health Care System Emerges From The Shadows

Lear, Julia Graham

doi:10.1377/hlthaff.26.2.409

Cited by 69 publications

(69 citation statements)

References 2 publications

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“…While these SBHCs may not be the primary care provider due to their seasonal nature or operation during school hours only, they can function as a coordinated medical home with the primary care provider for most chronically ill children. 3 The SBHC can monitor and ensure proper maintenance regimes for the child, reducing more expensive, acute care. 8,9,31 In fact, Guo et al found that two different subsets of chronically ill children enrolled in Medicaid with access to an SBHC-one set with asthma and one set with mental health problems-had lower hospitalization and emergency room costs than Medicaid-enrolled children with no SBHC access.…”

Section: Discussionmentioning

confidence: 99%

Access and Utilization Patterns of School-Based Health Centers at Urban and Rural Elementary and Middle Schools

et al. 2008

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SYNOPSISObjective. 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.

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Section: Discussionmentioning

confidence: 99%

Access and Utilization Patterns of School-Based Health Centers at Urban and Rural Elementary and Middle Schools

et al. 2008

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“…Support mostly comes from the federal government, private and public foundations, Medicaid, health insurance companies, and the Healthy Schools/Healthy Communities program of the Bureaus of Primary Health and Maternal and Child Health. 45 NASBHC has been instrumental in trying to address funding and has suggested that SBHC services should be covered by SCHIP under Medicaid or related MCOs. [46][47][48][49] Prevention of costly mental health problems not only has economic implications but also important societal benefits.…”

Section: Discussionmentioning

confidence: 99%

Impact of School-Based Health Centers on Students with Mental Health Problems

Guo

Wade

Keller³

2008

Public Health Rep

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SYNOPSISObjectives. School-based health centers (SBHCs) play an increasingly major role in providing mental health services for students. This study evaluated the impact of SBHCs on mental health-care services and psychosocial healthrelated quality of life (HRQOL). 50.006, p50.9361) for urban and rural non-SBHC schools, respectively. Using data from 109 students with mental health problems based on Medicaid claims, the study found SBHC students had significantly lower total health-care costs (F55.524, p50.005) and lower costs of mental health services (F54.820, p50.010) compared with non-SBHC students. While improvements over time in HRQOL for SBHC students compared with non-SBHC students and students from non-SBHC schools were observed, only some were statistically significant.Conclusions. SBHC programs increase the proportion of students who receive mental health services and may improve pediatric HRQOL. SBHC students with mental health problems had lower total Medicaid reimbursements compared with non-SBHC students.

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“…Therefore, public contexts such as schools, hospitals, places of employment, etc. should be regarded as active partners in the construction of an equal and fair society that promotes a better quality of life for people with a chronic disease (Stainton, 2005;Lear, 2007), and as instrumental to their autonomy, well-being and empowerment.…”

Section: The Chronic Illness Life Experience From An Ecological Perspmentioning

confidence: 99%

The Values of Empowerment and Citizenship and the Experience of Children and Adolescents with a Chronic Disease

Pais

Guedes

Menezes

2012

Citizenship, Social and Economics Education

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In spite of becoming progressively common, chronic diseases are quite invisible in modern societies, as these silent diseases are relatively absent from public socio-political debates. As a consequence, social agents and institutions seem to reveal significant difficulties in coping with the singularities of children and adolescents with a chronic disease and their parents. This article stresses the importance of recognising children and adolescents with a chronic disease as citizens who have both special needs and special rights, and emphasises the important role of support associations as mediators among various actors in the health sphere (private, public, political, medical institutions …). This research focuses on the empowerment, well-being and participation behind the experience of chronic conditions as perceived by children and adolescents with chronic illnesses, their families, and health and educational professionals. The data collected includes interviews, focus group discussions, questionnaires and a family narrative. The results suggest that there is a strong need for alternative discourses about citizenship and participation in the life experiences of people with a chronic disease, especially because the quality of their life contexts appears to be a determinant factor for well-being and empowerment.

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Health At School: A Hidden Health Care System Emerges From The Shadows

Cited by 69 publications

References 2 publications

Access and Utilization Patterns of School-Based Health Centers at Urban and Rural Elementary and Middle Schools

Access and Utilization Patterns of School-Based Health Centers at Urban and Rural Elementary and Middle Schools

Impact of School-Based Health Centers on Students with Mental Health Problems

The Values of Empowerment and Citizenship and the Experience of Children and Adolescents with a Chronic Disease

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