Opening School-Based Health Centers in a Rural Setting: Effects on Emergency Department Use
ABSTRACT BACKGROUND Previous studies of urban school‐based health centers (SBHCs) have shown that SBHCs decrease emergency department (ED) utilization. This study seeks to evaluate the effect of SBHCs on ED utilization in a rural setting. METHODS This retrospective, controlled, quasi‐experimental st...
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| Veröffentlicht in: | The Journal of school health 2016-04, Vol.86 (4), p.242-249 |
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| container_title | The Journal of school health |
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| creator | Schwartz, Katherine E. Monie, Daphne Scribani, Melissa B. Krupa, Nicole L. Jenkins, Paul Leinhart, August Kjolhede, Chris L. |
| description | ABSTRACT
BACKGROUND
Previous studies of urban school‐based health centers (SBHCs) have shown that SBHCs decrease emergency department (ED) utilization. This study seeks to evaluate the effect of SBHCs on ED utilization in a rural setting.
METHODS
This retrospective, controlled, quasi‐experimental study used an ED patient data set from the Bassett Healthcare Network in rural New York to compare ED visits between school‐aged children from 12 SBHC schools before and after the SBHC opening. Time series analysis was used to determine trends in SBHC schools and 2 control schools without SBHCs over the 18‐year study period.
RESULTS
ED visit incidence densities for all 12 school districts combined showed a significant increase in ED visits post‐SBHC (Rate ratio (RR) = 1.15; p < .0001). This increase may, in part, be explained by the upward trend of ED visits in the region, as seen in the small, but significant, positive slope (RR = 0.0033, p < .0001) for control schools. There was variation in the change in incidence density post‐SBHC among school districts, with increases in 78% of schools.
CONCLUSIONS
The opening of SBHCs in rural settings results in a slight, but significant, increase in ED use, which is contrary to previous cross‐sectional studies in urban settings. |
| doi_str_mv | 10.1111/josh.12375 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_miscellaneous_1826527425</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A454932493</galeid><ericid>EJ1092379</ericid><sourcerecordid>A454932493</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5245-ae02608aee12a92f1994d8c1156c65101a0ee68bb0de6778b4346b4cddc0f7d33</originalsourceid><addsrcrecordid>eNqFkU2P0zAQhiMEYsvChTvIEheElMXfTrjtltKyKluJsnDgYDnOpE3XTYqdCPrvcUm3Bw4wsuXDPDPjd94keU7wBYnxdtOG9QWhTIkHyYgoLlMiJHmYjDCmNOUsJ2fJkxA2OIZi6nFyRmXOMGVilHxf7KCpmxVa2nXbuvTKBCjRDIzr1mgMTQc-oLpBBn3uvXFoCV0X8XdoUlVgu4DaBk224FfQ2D16Dzvju20sQ7cBniaPKuMCPDu-58nth8mX8SydL6Yfx5fz1ArKRWoAU4kzA0CoyWlF8pyXmSVRhJWCYGIwgMyKApcglcoKzrgsuC1LiytVMnaevB767nz7o4fQ6W0dLDhnGmj7oElGpaCKU_F_VKm4s3jyiL76C920vW-ikEjJHAtOMhKpdKBWxoGuG9vGlf3qbOscrEBHneOFvuSC54zGG_k3A299G4KHSu98vTV-rwnWBzf1wU39x80Ivzx-oS-2UJ7Qe_si8GIAwNf2lJ5cE5zHBgcNZMj_rB3s_zFKXy-Ws_uhR0V1iEpONcbfaakO6LebqRZXXz9Nb9hcY_Yb4T6_GQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1769054181</pqid></control><display><type>article</type><title>Opening School-Based Health Centers in a Rural Setting: Effects on Emergency Department Use</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Applied Social Sciences Index & Abstracts (ASSIA)</source><creator>Schwartz, Katherine E. ; Monie, Daphne ; Scribani, Melissa B. ; Krupa, Nicole L. ; Jenkins, Paul ; Leinhart, August ; Kjolhede, Chris L.</creator><creatorcontrib>Schwartz, Katherine E. ; Monie, Daphne ; Scribani, Melissa B. ; Krupa, Nicole L. ; Jenkins, Paul ; Leinhart, August ; Kjolhede, Chris L.</creatorcontrib><description>ABSTRACT
BACKGROUND
Previous studies of urban school‐based health centers (SBHCs) have shown that SBHCs decrease emergency department (ED) utilization. This study seeks to evaluate the effect of SBHCs on ED utilization in a rural setting.
METHODS
This retrospective, controlled, quasi‐experimental study used an ED patient data set from the Bassett Healthcare Network in rural New York to compare ED visits between school‐aged children from 12 SBHC schools before and after the SBHC opening. Time series analysis was used to determine trends in SBHC schools and 2 control schools without SBHCs over the 18‐year study period.
RESULTS
ED visit incidence densities for all 12 school districts combined showed a significant increase in ED visits post‐SBHC (Rate ratio (RR) = 1.15; p < .0001). This increase may, in part, be explained by the upward trend of ED visits in the region, as seen in the small, but significant, positive slope (RR = 0.0033, p < .0001) for control schools. There was variation in the change in incidence density post‐SBHC among school districts, with increases in 78% of schools.
CONCLUSIONS
The opening of SBHCs in rural settings results in a slight, but significant, increase in ED use, which is contrary to previous cross‐sectional studies in urban settings.</description><identifier>ISSN: 0022-4391</identifier><identifier>EISSN: 1746-1561</identifier><identifier>DOI: 10.1111/josh.12375</identifier><identifier>PMID: 26930235</identifier><identifier>CODEN: JSHEAZ</identifier><language>eng</language><publisher>Malden, USA: Wiley Periodicals, Inc</publisher><subject>Access to Health Care ; Adolescent ; Analysis ; Child ; child and adolescent health ; Child, Preschool ; Children ; Company business management ; Comparative Analysis ; Control methods ; Cross-Sectional Studies ; Density ; emergency care ; emergency department ; Emergency medical services ; Emergency service ; Emergency Service, Hospital - utilization ; Emergency services ; Female ; Health care ; Hospital emergency services ; Hospitalization ; Hospitals ; Humans ; Incidence ; Male ; Management ; New York ; Nursing ; Program Effectiveness ; Quasiexperimental Design ; Retrospective Studies ; Rural communities ; Rural health ; Rural health care ; Rural Population ; Rural Schools ; School based ; School Districts ; School Health Services ; school-based health centers ; School-based health clinics ; Schools ; Services ; Time series ; Urban environments ; Urban Schools ; Visits</subject><ispartof>The Journal of school health, 2016-04, Vol.86 (4), p.242-249</ispartof><rights>2016, American School Health Association</rights><rights>2016, American School Health Association.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5245-ae02608aee12a92f1994d8c1156c65101a0ee68bb0de6778b4346b4cddc0f7d33</citedby><cites>FETCH-LOGICAL-c5245-ae02608aee12a92f1994d8c1156c65101a0ee68bb0de6778b4346b4cddc0f7d33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjosh.12375$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjosh.12375$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,30998,45573,45574</link.rule.ids><backlink>$$Uhttp://eric.ed.gov/ERICWebPortal/detail?accno=EJ1092379$$DView record in ERIC$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26930235$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Schwartz, Katherine E.</creatorcontrib><creatorcontrib>Monie, Daphne</creatorcontrib><creatorcontrib>Scribani, Melissa B.</creatorcontrib><creatorcontrib>Krupa, Nicole L.</creatorcontrib><creatorcontrib>Jenkins, Paul</creatorcontrib><creatorcontrib>Leinhart, August</creatorcontrib><creatorcontrib>Kjolhede, Chris L.</creatorcontrib><title>Opening School-Based Health Centers in a Rural Setting: Effects on Emergency Department Use</title><title>The Journal of school health</title><addtitle>J School Health</addtitle><description>ABSTRACT
BACKGROUND
Previous studies of urban school‐based health centers (SBHCs) have shown that SBHCs decrease emergency department (ED) utilization. This study seeks to evaluate the effect of SBHCs on ED utilization in a rural setting.
METHODS
This retrospective, controlled, quasi‐experimental study used an ED patient data set from the Bassett Healthcare Network in rural New York to compare ED visits between school‐aged children from 12 SBHC schools before and after the SBHC opening. Time series analysis was used to determine trends in SBHC schools and 2 control schools without SBHCs over the 18‐year study period.
RESULTS
ED visit incidence densities for all 12 school districts combined showed a significant increase in ED visits post‐SBHC (Rate ratio (RR) = 1.15; p < .0001). This increase may, in part, be explained by the upward trend of ED visits in the region, as seen in the small, but significant, positive slope (RR = 0.0033, p < .0001) for control schools. There was variation in the change in incidence density post‐SBHC among school districts, with increases in 78% of schools.
CONCLUSIONS
The opening of SBHCs in rural settings results in a slight, but significant, increase in ED use, which is contrary to previous cross‐sectional studies in urban settings.</description><subject>Access to Health Care</subject><subject>Adolescent</subject><subject>Analysis</subject><subject>Child</subject><subject>child and adolescent health</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Company business management</subject><subject>Comparative Analysis</subject><subject>Control methods</subject><subject>Cross-Sectional Studies</subject><subject>Density</subject><subject>emergency care</subject><subject>emergency department</subject><subject>Emergency medical services</subject><subject>Emergency service</subject><subject>Emergency Service, Hospital - utilization</subject><subject>Emergency services</subject><subject>Female</subject><subject>Health care</subject><subject>Hospital emergency services</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Incidence</subject><subject>Male</subject><subject>Management</subject><subject>New York</subject><subject>Nursing</subject><subject>Program Effectiveness</subject><subject>Quasiexperimental Design</subject><subject>Retrospective Studies</subject><subject>Rural communities</subject><subject>Rural health</subject><subject>Rural health care</subject><subject>Rural Population</subject><subject>Rural Schools</subject><subject>School based</subject><subject>School Districts</subject><subject>School Health Services</subject><subject>school-based health centers</subject><subject>School-based health clinics</subject><subject>Schools</subject><subject>Services</subject><subject>Time series</subject><subject>Urban environments</subject><subject>Urban Schools</subject><subject>Visits</subject><issn>0022-4391</issn><issn>1746-1561</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqFkU2P0zAQhiMEYsvChTvIEheElMXfTrjtltKyKluJsnDgYDnOpE3XTYqdCPrvcUm3Bw4wsuXDPDPjd94keU7wBYnxdtOG9QWhTIkHyYgoLlMiJHmYjDCmNOUsJ2fJkxA2OIZi6nFyRmXOMGVilHxf7KCpmxVa2nXbuvTKBCjRDIzr1mgMTQc-oLpBBn3uvXFoCV0X8XdoUlVgu4DaBk224FfQ2D16Dzvju20sQ7cBniaPKuMCPDu-58nth8mX8SydL6Yfx5fz1ArKRWoAU4kzA0CoyWlF8pyXmSVRhJWCYGIwgMyKApcglcoKzrgsuC1LiytVMnaevB767nz7o4fQ6W0dLDhnGmj7oElGpaCKU_F_VKm4s3jyiL76C920vW-ikEjJHAtOMhKpdKBWxoGuG9vGlf3qbOscrEBHneOFvuSC54zGG_k3A299G4KHSu98vTV-rwnWBzf1wU39x80Ivzx-oS-2UJ7Qe_si8GIAwNf2lJ5cE5zHBgcNZMj_rB3s_zFKXy-Ws_uhR0V1iEpONcbfaakO6LebqRZXXz9Nb9hcY_Yb4T6_GQ</recordid><startdate>201604</startdate><enddate>201604</enddate><creator>Schwartz, Katherine E.</creator><creator>Monie, Daphne</creator><creator>Scribani, Melissa B.</creator><creator>Krupa, Nicole L.</creator><creator>Jenkins, Paul</creator><creator>Leinhart, August</creator><creator>Kjolhede, Chris L.</creator><general>Wiley Periodicals, Inc</general><general>Wiley-Blackwell</general><general>American School Health Association</general><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>7SW</scope><scope>BJH</scope><scope>BNH</scope><scope>BNI</scope><scope>BNJ</scope><scope>BNO</scope><scope>ERI</scope><scope>PET</scope><scope>REK</scope><scope>WWN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TS</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201604</creationdate><title>Opening School-Based Health Centers in a Rural Setting: Effects on Emergency Department Use</title><author>Schwartz, Katherine E. ; Monie, Daphne ; Scribani, Melissa B. ; Krupa, Nicole L. ; Jenkins, Paul ; Leinhart, August ; Kjolhede, Chris L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5245-ae02608aee12a92f1994d8c1156c65101a0ee68bb0de6778b4346b4cddc0f7d33</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Access to Health Care</topic><topic>Adolescent</topic><topic>Analysis</topic><topic>Child</topic><topic>child and adolescent health</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Company business management</topic><topic>Comparative Analysis</topic><topic>Control methods</topic><topic>Cross-Sectional Studies</topic><topic>Density</topic><topic>emergency care</topic><topic>emergency department</topic><topic>Emergency medical services</topic><topic>Emergency service</topic><topic>Emergency Service, Hospital - utilization</topic><topic>Emergency services</topic><topic>Female</topic><topic>Health care</topic><topic>Hospital emergency services</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Incidence</topic><topic>Male</topic><topic>Management</topic><topic>New York</topic><topic>Nursing</topic><topic>Program Effectiveness</topic><topic>Quasiexperimental Design</topic><topic>Retrospective Studies</topic><topic>Rural communities</topic><topic>Rural health</topic><topic>Rural health care</topic><topic>Rural Population</topic><topic>Rural Schools</topic><topic>School based</topic><topic>School Districts</topic><topic>School Health Services</topic><topic>school-based health centers</topic><topic>School-based health clinics</topic><topic>Schools</topic><topic>Services</topic><topic>Time series</topic><topic>Urban environments</topic><topic>Urban Schools</topic><topic>Visits</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Schwartz, Katherine E.</creatorcontrib><creatorcontrib>Monie, Daphne</creatorcontrib><creatorcontrib>Scribani, Melissa B.</creatorcontrib><creatorcontrib>Krupa, Nicole L.</creatorcontrib><creatorcontrib>Jenkins, Paul</creatorcontrib><creatorcontrib>Leinhart, August</creatorcontrib><creatorcontrib>Kjolhede, Chris L.</creatorcontrib><collection>Istex</collection><collection>ERIC</collection><collection>ERIC (Ovid)</collection><collection>ERIC</collection><collection>ERIC</collection><collection>ERIC (Legacy Platform)</collection><collection>ERIC( SilverPlatter )</collection><collection>ERIC</collection><collection>ERIC PlusText (Legacy Platform)</collection><collection>Education Resources Information Center (ERIC)</collection><collection>ERIC</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Physical Education Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of school health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Schwartz, Katherine E.</au><au>Monie, Daphne</au><au>Scribani, Melissa B.</au><au>Krupa, Nicole L.</au><au>Jenkins, Paul</au><au>Leinhart, August</au><au>Kjolhede, Chris L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><ericid>EJ1092379</ericid><atitle>Opening School-Based Health Centers in a Rural Setting: Effects on Emergency Department Use</atitle><jtitle>The Journal of school health</jtitle><addtitle>J School Health</addtitle><date>2016-04</date><risdate>2016</risdate><volume>86</volume><issue>4</issue><spage>242</spage><epage>249</epage><pages>242-249</pages><issn>0022-4391</issn><eissn>1746-1561</eissn><coden>JSHEAZ</coden><abstract>ABSTRACT
BACKGROUND
Previous studies of urban school‐based health centers (SBHCs) have shown that SBHCs decrease emergency department (ED) utilization. This study seeks to evaluate the effect of SBHCs on ED utilization in a rural setting.
METHODS
This retrospective, controlled, quasi‐experimental study used an ED patient data set from the Bassett Healthcare Network in rural New York to compare ED visits between school‐aged children from 12 SBHC schools before and after the SBHC opening. Time series analysis was used to determine trends in SBHC schools and 2 control schools without SBHCs over the 18‐year study period.
RESULTS
ED visit incidence densities for all 12 school districts combined showed a significant increase in ED visits post‐SBHC (Rate ratio (RR) = 1.15; p < .0001). This increase may, in part, be explained by the upward trend of ED visits in the region, as seen in the small, but significant, positive slope (RR = 0.0033, p < .0001) for control schools. There was variation in the change in incidence density post‐SBHC among school districts, with increases in 78% of schools.
CONCLUSIONS
The opening of SBHCs in rural settings results in a slight, but significant, increase in ED use, which is contrary to previous cross‐sectional studies in urban settings.</abstract><cop>Malden, USA</cop><pub>Wiley Periodicals, Inc</pub><pmid>26930235</pmid><doi>10.1111/josh.12375</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | The Journal of school health, 2016-04, Vol.86 (4), p.242-249 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Applied Social Sciences Index & Abstracts (ASSIA) |
| subjects | Access to Health Care Adolescent Analysis Child child and adolescent health Child, Preschool Children Company business management Comparative Analysis Control methods Cross-Sectional Studies Density emergency care emergency department Emergency medical services Emergency service Emergency Service, Hospital - utilization Emergency services Female Health care Hospital emergency services Hospitalization Hospitals Humans Incidence Male Management New York Nursing Program Effectiveness Quasiexperimental Design Retrospective Studies Rural communities Rural health Rural health care Rural Population Rural Schools School based School Districts School Health Services school-based health centers School-based health clinics Schools Services Time series Urban environments Urban Schools Visits |
| title | Opening School-Based Health Centers in a Rural Setting: Effects on Emergency Department Use |
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