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ED visits rise slightly in rural areas with school-based health centers
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New research in the Journal of School Health found that opening school-based health centers in rural communities may slightly increase the amount of ED visits among children, contrary to previous research that focused on urban areas.
“The results of our analysis of ED use in a rural area before and after the opening of [school-based health centers (SBHCs)] are not consistent with previously reported studies and are contrary to our hypothesis,” Katherine E. Schwartz, MD, of the department of pediatrics at Mount Sinai Hospital, New York, and colleagues wrote. “The disagreement of our study results with previous findings could be explained by the difference in settings, rural vs. urban, or difference in study design.”
The researchers retrospectively analyzed data from students aged 5 to 18 years at 12 school districts in rural New York from 1996 to 2013. Data were gathered using the Bassett Health Care network, which contained ED visit records for study participants. Trends in ED visits before the opening of SBHCs were compared with ED visits after the opening of SBHCs. Two school districts without SBHCs were used as controls.
Study results showed that ED visit densities increased after SBHCs opened for all school districts with SBHCs (928/10,000 student-years vs. 809/10,000 student-years; rate ratio = 1.15; 95% CI, 1.11-1.19). The researchers noted that part of this increase may be a result of an overall upward trend in ED visits, as increases also occurred in the control schools.
The researchers posit that the increase in ED visits may be explained by an increase in overall health care participation caused by SBHC enrollment.
“SBHCs also function to identify children who do not have health care coverage who are eligible for enrollment in federal or state health insurance programs,” Schwartz and colleagues wrote. “Therefore, SBHCs may increase the number of children with coverage, and thus, their utilization of health care services, including the ED.” – by David Costill
Disclosure: The researchers report no relevant financial disclosures.
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