Elementary School—Based Health Centers and Access to Preventive and Asthma-Related Care Among Publicly Insured Children With Asthma in Georgia
Objectives We assessed the effects of 3 new elementary school–based health centers (SBHCs) in disparate Georgia communities—predominantly non-Hispanic Black semi-urban, predominantly Hispanic urban, and predominantly non-Hispanic White rural—on asthma case management among children insured by Medica...
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| Veröffentlicht in: | Public health reports (1974) 2022-09, Vol.137 (5), p.901-911 |
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| creator | Adams, Kathleen Johnson, Veda C. Hogue, Carol J. Franco-Montoya, Daniela Joski, Peter J. Hawley, Jonathan N. |
| description | Objectives
We assessed the effects of 3 new elementary school–based health centers (SBHCs) in disparate Georgia communities—predominantly non-Hispanic Black semi-urban, predominantly Hispanic urban, and predominantly non-Hispanic White rural—on asthma case management among children insured by Medicaid/Children’s Health Insurance Program (CHIP).
Methods
We used a quasi-experimental difference-in-differences analysis to measure changes in the treatment of children with asthma, Medicaid/CHIP, and access to an SBHC (treatment, n = 193) and children in the same county without such access (control, n = 163) in school years 2011-2013 and 2013-2018. Among children with access to an SBHC (n = 193), we tested for differences between users (34%) and nonusers of SBHCs. We used International Classification of Diseases diagnosis codes, Current Procedural Terminology codes, and National Drug Codes to measure well-child visits and influenza immunization; ≥3 asthma-related visits, asthma-relief medication, asthma-control medication, and ≥2 asthma-control medications; and emergency department visits during the child–school year.
Results
We found an increase of about 19 (P = .01) to 33 (P < .001) percentage points in the probability of having ≥3 asthma-related visits per child–school year and an increase of about 22 (P = .003) to 24 (P < .001) percentage points in the receipt of asthma-relief medication, among users of the predominantly non-Hispanic Black and Hispanic SBHCs. We found a 19 (P = .01) to 29 (P < .001) percentage-point increase in receipt of asthma-control medication and a 15 (P = .03) to 30 (P < .001) percentage-point increase in receipt of ≥2 asthma-control medications among users. Increases were largest in the predominantly non-Hispanic Black SBHC.
Conclusion
Implementation and use of elementary SBHCs can increase case management and recommended medications among racial/ethnic minority and publicly insured children with asthma. |
| doi_str_mv | 10.1177/00333549211032973 |
| format | Article |
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We assessed the effects of 3 new elementary school–based health centers (SBHCs) in disparate Georgia communities—predominantly non-Hispanic Black semi-urban, predominantly Hispanic urban, and predominantly non-Hispanic White rural—on asthma case management among children insured by Medicaid/Children’s Health Insurance Program (CHIP).
Methods
We used a quasi-experimental difference-in-differences analysis to measure changes in the treatment of children with asthma, Medicaid/CHIP, and access to an SBHC (treatment, n = 193) and children in the same county without such access (control, n = 163) in school years 2011-2013 and 2013-2018. Among children with access to an SBHC (n = 193), we tested for differences between users (34%) and nonusers of SBHCs. We used International Classification of Diseases diagnosis codes, Current Procedural Terminology codes, and National Drug Codes to measure well-child visits and influenza immunization; ≥3 asthma-related visits, asthma-relief medication, asthma-control medication, and ≥2 asthma-control medications; and emergency department visits during the child–school year.
Results
We found an increase of about 19 (P = .01) to 33 (P < .001) percentage points in the probability of having ≥3 asthma-related visits per child–school year and an increase of about 22 (P = .003) to 24 (P < .001) percentage points in the receipt of asthma-relief medication, among users of the predominantly non-Hispanic Black and Hispanic SBHCs. We found a 19 (P = .01) to 29 (P < .001) percentage-point increase in receipt of asthma-control medication and a 15 (P = .03) to 30 (P < .001) percentage-point increase in receipt of ≥2 asthma-control medications among users. Increases were largest in the predominantly non-Hispanic Black SBHC.
Conclusion
Implementation and use of elementary SBHCs can increase case management and recommended medications among racial/ethnic minority and publicly insured children with asthma.</description><identifier>ISSN: 0033-3549</identifier><identifier>EISSN: 1468-2877</identifier><identifier>DOI: 10.1177/00333549211032973</identifier><identifier>PMID: 34436955</identifier><language>eng</language><publisher>Los Angeles, CA: Sage Publications, Inc</publisher><subject>Access ; Access control ; Asthma ; Case management ; Children ; Children & youth ; Childrens health ; Classification ; Drugs ; Emergency medical care ; Emergency medical services ; Health care industry ; Health facilities ; Health insurance ; Hispanic Americans ; Immunization ; Influenza ; Medicaid ; Minority & ethnic groups ; Minority groups ; Public health ; Quasi-experimental methods ; Terminology</subject><ispartof>Public health reports (1974), 2022-09, Vol.137 (5), p.901-911</ispartof><rights>2021, Association of Schools and Programs of Public Health</rights><rights>2021, Association of Schools and Programs of Public Health 2021 US Surgeon General’s Office</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c465t-441a020617ea90fdf5cff925af77f8fb39bbf660eed9d2aa9b35ec870520a09c3</citedby><cites>FETCH-LOGICAL-c465t-441a020617ea90fdf5cff925af77f8fb39bbf660eed9d2aa9b35ec870520a09c3</cites><orcidid>0000-0002-4811-2752</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379825/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9379825/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,21798,27843,27901,27902,43597,43598,53766,53768</link.rule.ids></links><search><creatorcontrib>Adams, Kathleen</creatorcontrib><creatorcontrib>Johnson, Veda C.</creatorcontrib><creatorcontrib>Hogue, Carol J.</creatorcontrib><creatorcontrib>Franco-Montoya, Daniela</creatorcontrib><creatorcontrib>Joski, Peter J.</creatorcontrib><creatorcontrib>Hawley, Jonathan N.</creatorcontrib><title>Elementary School—Based Health Centers and Access to Preventive and Asthma-Related Care Among Publicly Insured Children With Asthma in Georgia</title><title>Public health reports (1974)</title><description>Objectives
We assessed the effects of 3 new elementary school–based health centers (SBHCs) in disparate Georgia communities—predominantly non-Hispanic Black semi-urban, predominantly Hispanic urban, and predominantly non-Hispanic White rural—on asthma case management among children insured by Medicaid/Children’s Health Insurance Program (CHIP).
Methods
We used a quasi-experimental difference-in-differences analysis to measure changes in the treatment of children with asthma, Medicaid/CHIP, and access to an SBHC (treatment, n = 193) and children in the same county without such access (control, n = 163) in school years 2011-2013 and 2013-2018. Among children with access to an SBHC (n = 193), we tested for differences between users (34%) and nonusers of SBHCs. We used International Classification of Diseases diagnosis codes, Current Procedural Terminology codes, and National Drug Codes to measure well-child visits and influenza immunization; ≥3 asthma-related visits, asthma-relief medication, asthma-control medication, and ≥2 asthma-control medications; and emergency department visits during the child–school year.
Results
We found an increase of about 19 (P = .01) to 33 (P < .001) percentage points in the probability of having ≥3 asthma-related visits per child–school year and an increase of about 22 (P = .003) to 24 (P < .001) percentage points in the receipt of asthma-relief medication, among users of the predominantly non-Hispanic Black and Hispanic SBHCs. We found a 19 (P = .01) to 29 (P < .001) percentage-point increase in receipt of asthma-control medication and a 15 (P = .03) to 30 (P < .001) percentage-point increase in receipt of ≥2 asthma-control medications among users. Increases were largest in the predominantly non-Hispanic Black SBHC.
Conclusion
Implementation and use of elementary SBHCs can increase case management and recommended medications among racial/ethnic minority and publicly insured children with asthma.</description><subject>Access</subject><subject>Access control</subject><subject>Asthma</subject><subject>Case management</subject><subject>Children</subject><subject>Children & youth</subject><subject>Childrens health</subject><subject>Classification</subject><subject>Drugs</subject><subject>Emergency medical care</subject><subject>Emergency medical services</subject><subject>Health care industry</subject><subject>Health facilities</subject><subject>Health insurance</subject><subject>Hispanic Americans</subject><subject>Immunization</subject><subject>Influenza</subject><subject>Medicaid</subject><subject>Minority & ethnic groups</subject><subject>Minority groups</subject><subject>Public health</subject><subject>Quasi-experimental methods</subject><subject>Terminology</subject><issn>0033-3549</issn><issn>1468-2877</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>7TQ</sourceid><recordid>eNp9kcuKFDEYhYMoTs_oA7gQAm7c1JhLpVLZCG0zNxhw8ILLkEr91ZUmVRmTqobZ-QgufEKfxDQ1jKhgNll855z_htALSk4plfINIZxzUSpGKeFMSf4IrWhZ1QWrpXyMVgdeHARH6DilHcmPUf4UHfGy5JUSYoW-n3kYYJxMvMMfbR-C__ntxzuToMWXYPzU402mEBM2Y4vX1kJKeAr4JsI-A7eHBaSpH0zxAbyZsnVjIuD1EMYtvpkb76y_w1djmuOB9c63EUb8xeX0xYjdiC8gxK0zz9CTzvgEz-__E_T5_OzT5rK4fn9xtVlfF7asxFSUJTWEkYpKMIp0bSds1ykmTCdlV3cNV03TVRUBaFXLjFENF2BrSQQjhijLT9DbJfd2bgZobR4mGq9voxvyLnQwTv9JRtfrbdhrxaWqmcgBr-8DYvg6Q5r04JIF780IYU6aiVye81pUWfrqL-kuzHHM42kmSW6Jy7LOKrqobAwpRegemqFEH-6t_7l39pwunmS28Dv1f4aXi2GXphAfKjBJFSlVxX8Bl221Tw</recordid><startdate>20220901</startdate><enddate>20220901</enddate><creator>Adams, Kathleen</creator><creator>Johnson, Veda C.</creator><creator>Hogue, Carol J.</creator><creator>Franco-Montoya, Daniela</creator><creator>Joski, Peter J.</creator><creator>Hawley, Jonathan N.</creator><general>Sage Publications, Inc</general><general>SAGE Publications</general><general>SAGE PUBLICATIONS, INC</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7TQ</scope><scope>ASE</scope><scope>DHY</scope><scope>DON</scope><scope>FPQ</scope><scope>K6X</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-4811-2752</orcidid></search><sort><creationdate>20220901</creationdate><title>Elementary School—Based Health Centers and Access to Preventive and Asthma-Related Care Among Publicly Insured Children With Asthma in Georgia</title><author>Adams, Kathleen ; Johnson, Veda C. ; Hogue, Carol J. ; Franco-Montoya, Daniela ; Joski, Peter J. ; Hawley, Jonathan N.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c465t-441a020617ea90fdf5cff925af77f8fb39bbf660eed9d2aa9b35ec870520a09c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Access</topic><topic>Access control</topic><topic>Asthma</topic><topic>Case management</topic><topic>Children</topic><topic>Children & youth</topic><topic>Childrens health</topic><topic>Classification</topic><topic>Drugs</topic><topic>Emergency medical care</topic><topic>Emergency medical services</topic><topic>Health care industry</topic><topic>Health facilities</topic><topic>Health insurance</topic><topic>Hispanic Americans</topic><topic>Immunization</topic><topic>Influenza</topic><topic>Medicaid</topic><topic>Minority & ethnic groups</topic><topic>Minority groups</topic><topic>Public health</topic><topic>Quasi-experimental methods</topic><topic>Terminology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Adams, Kathleen</creatorcontrib><creatorcontrib>Johnson, Veda C.</creatorcontrib><creatorcontrib>Hogue, Carol J.</creatorcontrib><creatorcontrib>Franco-Montoya, Daniela</creatorcontrib><creatorcontrib>Joski, Peter J.</creatorcontrib><creatorcontrib>Hawley, Jonathan N.</creatorcontrib><collection>CrossRef</collection><collection>PAIS Index</collection><collection>British Nursing Index</collection><collection>PAIS International</collection><collection>PAIS International (Ovid)</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Public health reports (1974)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Adams, Kathleen</au><au>Johnson, Veda C.</au><au>Hogue, Carol J.</au><au>Franco-Montoya, Daniela</au><au>Joski, Peter J.</au><au>Hawley, Jonathan N.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Elementary School—Based Health Centers and Access to Preventive and Asthma-Related Care Among Publicly Insured Children With Asthma in Georgia</atitle><jtitle>Public health reports (1974)</jtitle><date>2022-09-01</date><risdate>2022</risdate><volume>137</volume><issue>5</issue><spage>901</spage><epage>911</epage><pages>901-911</pages><issn>0033-3549</issn><eissn>1468-2877</eissn><abstract>Objectives
We assessed the effects of 3 new elementary school–based health centers (SBHCs) in disparate Georgia communities—predominantly non-Hispanic Black semi-urban, predominantly Hispanic urban, and predominantly non-Hispanic White rural—on asthma case management among children insured by Medicaid/Children’s Health Insurance Program (CHIP).
Methods
We used a quasi-experimental difference-in-differences analysis to measure changes in the treatment of children with asthma, Medicaid/CHIP, and access to an SBHC (treatment, n = 193) and children in the same county without such access (control, n = 163) in school years 2011-2013 and 2013-2018. Among children with access to an SBHC (n = 193), we tested for differences between users (34%) and nonusers of SBHCs. We used International Classification of Diseases diagnosis codes, Current Procedural Terminology codes, and National Drug Codes to measure well-child visits and influenza immunization; ≥3 asthma-related visits, asthma-relief medication, asthma-control medication, and ≥2 asthma-control medications; and emergency department visits during the child–school year.
Results
We found an increase of about 19 (P = .01) to 33 (P < .001) percentage points in the probability of having ≥3 asthma-related visits per child–school year and an increase of about 22 (P = .003) to 24 (P < .001) percentage points in the receipt of asthma-relief medication, among users of the predominantly non-Hispanic Black and Hispanic SBHCs. We found a 19 (P = .01) to 29 (P < .001) percentage-point increase in receipt of asthma-control medication and a 15 (P = .03) to 30 (P < .001) percentage-point increase in receipt of ≥2 asthma-control medications among users. Increases were largest in the predominantly non-Hispanic Black SBHC.
Conclusion
Implementation and use of elementary SBHCs can increase case management and recommended medications among racial/ethnic minority and publicly insured children with asthma.</abstract><cop>Los Angeles, CA</cop><pub>Sage Publications, Inc</pub><pmid>34436955</pmid><doi>10.1177/00333549211032973</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-4811-2752</orcidid><oa>free_for_read</oa></addata></record> |
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| source | PAIS Index; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SAGE Complete; PubMed Central; Alma/SFX Local Collection |
| subjects | Access Access control Asthma Case management Children Children & youth Childrens health Classification Drugs Emergency medical care Emergency medical services Health care industry Health facilities Health insurance Hispanic Americans Immunization Influenza Medicaid Minority & ethnic groups Minority groups Public health Quasi-experimental methods Terminology |
| title | Elementary School—Based Health Centers and Access to Preventive and Asthma-Related Care Among Publicly Insured Children With Asthma in Georgia |
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