Wide support for school-based health centers

"These centers are focused on increasing access to care for underserved students, especially adolescents," said study author Sean O'Leary, MD, MPH, an investigator at the Children's Outcomes Research Program, affiliated with the University of Colorado School of Medicine and Children's Hospital Colorado. "Students can get check-ups, vaccinations, sick visits, mental health counseling and access to a pharmacy. And there is generally no co-payment."

O'Leary presented the studies last week at the American Academy of Pediatrics National Conference and Exhibition in Orlando, Fla. The research will be published in the coming months.

The first study surveyed a random sample of 497 parents of adolescents in one of Denver's 15 SBHCs, seeking to gauge their feelings about the centers.

Some 83 percent said they could always or usually trust the center provider to take good care of their child and 82 percent were satisfied with the level of communication with the provider. Significantly, 33 percent reported that SBHCs were their child's main source of medical care.

Of the parents surveyed, 77 percent said the main reason they came to the centers was get their children vaccinated; 70 percent said they came for regular check-ups and 62 percent cited illness as the reason for visiting.

The second study surveyed a random sample of 495 adolescents who had used a school-based health center. Seventy- nine percent visited a center roughly three times in the last year and 34 percent said it was their primary source of medical care.

The study also showed that 67 percent of teens were very satisfied with their care and 30 percent were somewhat satisfied.

Breaking it down further, the study showed that 88 percent of teens said providers were usually or always helpful; 88 percent said they explained things well and 93 percent said they showed respect.

The average age of the students surveyed was 15.8. Of those, 69 percent were Latino; 19 percent were African-American and 15 percent were white.

"These studies are significant because they show the centers are a different way for medical providers to deliver health care to kids," said Sonja O'Leary, MD, medical director for Denver's SBHCs which are affiliated with Denver Health. "We are meeting kids where they are and that is in the schools."

There are currently about 2,000 centers nationwide. The Affordable Care Act earmarks $200 million to build even more. In Denver, they are generally staffed by nurse practitioners and physician assistants with oversight by pediatricians.

All of this has important implications for health care policy and policy makers.

"Our studies show that SBHCs work and can serve as patient-centered medical homes -- places where people get their primary health care needs met," said Sean O'Leary. "And it's significant that for a full one-third of these students, this is their only source of health care."

O'Leary also noted that chronic illness is often reason for poor academic performance.

"Kids with unmet health needs are at risk of dropping out," he said. "And we think school-based health centers can help decrease that likelihood."