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School-based health centers reduce asthma-related hospitalization and absenteeism among urban children

About 1,400 school-based health centers (SBHCs) provide care to 1.1 million children in the United States. Inner city children who have asthma and attend elementary schools with SBHCs are hospitalized less often and miss fewer days of school than similar children whose schools do not have SBHCs. These SBHCs appear to offer a practical response to the limited access that poor and uninsured children have to health care, concludes Mayris P. Webber, Dr.P.H., of Montefiore Medical Center.

In a study supported by the Agency for Healthcare Research and Quality (HS10136), Dr. Webber and colleagues began a 3-year project in 1999-2000 to evaluate whether the availability of SBHC services measurably affected the health and school performance of 949 children with asthma attending six Bronx elementary schools (four schools with and two without SBHCs). They compared the outcomes of children with asthma at the SBHC and non-SBHC schools, including hospitalizations, emergency department (ED) visits, and school absenteeism.

Based on parent surveys, the prevalence of asthma in the six schools was 20 percent, and asthma symptoms and problems were high. During the previous year, 46 percent of the children had been treated for asthma in the ED, and 13 percent had been hospitalized. ED use was not associated with SBHCs. However, the rate of hospitalization was much higher among children attending schools without an SBHC compared with children whose schools had an SBHC (17 vs. 11 percent). Furthermore, children with asthma attending schools without an SBHC missed an average of 3 more days of school than those enrolled in schools with an SBHC (21 vs. 18 days). Since SBHCs are associated with fewer hospitalizations and fewer missed days of school, SBHCs may reduce asthma-associated costs while increasing access to health care.

See "Burden of asthma in inner-city elementary schoolchildren: Do school-based health centers make a difference?" by Dr. Webber, Kelly E. Carpiniello, M.A., Tosan Oruwariye, M.D., M.P.H., and others, in the February 2003 Archives of Pediatric and Adolescent Medicine 157, pp. 125-129.

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