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Parents, patients report satisfaction with school-based health centers

ORLANDO, Fla. — Two new studies presented here suggest that both parents and adolescents are highly satisfied with the quality of care from school-based health centers, and that these centers can potentially serve as patient-centered medical homes for students.

The AAP defines a patient-centered medical home (PCMH) as care that is accessible, continuous, comprehensive, family-centered, coordinated, compassionate and culturally effective.

In the first study, Sean O'Leary, MD, MPH, of the children's outcomes research program, affiliated with Children's Hospital Colorado and the University of Colorado School of Medicine, and colleagues surveyed a random sample of 497 parents of adolescents enrolled in one of 10 Denver school-based health centers (SBHCs). A $5 incentive was included in the first mailed survey, and up to five mailings were sent. All of the SBHCs in the study are located in secondary schools and operated by the same mail delivery system, according to the researchers.

 

Sean O'Leary

The response rate was 36%. Thirty-three percent of parents said the SBHC was their child's main source of care. Results also indicated that 83% of respondents said they could always or usually trust the SBHC provider to take good care of their child, and 82% reported that they were satisfied with communication between providers. Vaccines (77%), regular check ups (70%) and illnesses (62%) were the most common reasons parents gave for SBHC visits.

According to the researchers, the reasons parents choose to send their children to SBHCs are similar to those for traditional primary care centers.

"There is significant value placed by parents on SBHCs' convenience, provision of desired services and lack of financial barriers to care," they said.

In the second study, O'Leary and colleagues again mailed out surveys, but this time to a random sample of 495 adolescents who were registered for the SBHC with at least one visit during the 2011-2012 school year. All of the AAP criteria for a PCMH were assessed, with the exception of family-centered care.

For the second study, there was a 40% response rate. Among adolescents, 79% said they visited a SBHC ≥3 times in the past year, and 34% reported that the SBHC was their main source of medical care. Nineteen percent of the sample reported having a chronic medical condition. A majority of the adolescents were very (67%) or somewhat (30%) satisfied with the care they had received at the SBHC.

In terms of quality of care, a large majority of patients said the providers were usually or always helpful (88%), and that the providers listened carefully (88%), explained things well (88%), showed respect (93%), spent adequate time with the patient (85%) and explained that care was confidential (90%).

"In a low-income urban population, SBHCs met most criteria of a PCMH from the perspective of teens they served," the researchers said. "Policy makers and communities should consider SBHCs as a way to provide a medical home for underserved adolescents while addressing any areas of weakness."

For more information:

O'Leary S. Abstract #22992 A. Presented at: AAP National Conference and Exhibition; Oct. 26-29, 2013; Orlando, Florida.

O'Leary S. Abstract #22993 A. Presented at: AAP National Conference and Exhibition; Oct. 26-29, 2013; Orlando, Florida.

Disclosure: The researchers report no relevant financial disclosures.