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Healthcare + Education = Healthy Communities: Why Schools Fit the Equation. Kate Keller, MPA Senior Program Officer The Health Foundation of Greater Cincinnati. National Picture of SBHCs. Over 1700 SBHCs in 2005 87% located in the school building - PowerPoint PPT Presentation
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Health Care + Education = Healthy Communities: Why Schools Fit the Equation
SCHOOL HEALTH INITIATIVES MIDWESTERN REGIONAL CONFERENCE
July 23-24, 2008
Sponsored in part by:
ICSHC
National Covering Kids & Families Network
Healthcare + Education = Healthy Communities: Why
Schools Fit the Equation
Kate Keller, MPASenior Program Officer
The Health Foundation of Greater Cincinnati
National Picture of SBHCs
• Over 1700 SBHCs in 2005
• 87% located in the school building
• 30% high schools; 80% serving at least one adolescent grade
• 34% Hispanic; 30% Black; 30% White
• 59% in urban areas
• Midwest region: 275 SBHCs
Who we serve
• 12 School-Based Health Centers
• 31 Schools Served
• 8,050 students enrolled (76% of student population)
• 52% Medicaid; 16% uninsured
• 16,791 encounters
What we learned
Improved Health Status
Child-Reported Total HRQL (N=588)
70
72
74
76
78
80
Year 1 Year 2 Year 3
Ped
sQL
Sco
re
SBHC User SBHC NonUser Comparison
What we learned
Improved mental health status
Child-Reported Psychosocial HRQL (N=588)
68
70
72
74
76
78
Year 1 Year 2 Year 3
Ped
sQL
Sco
re
SBHC User SBHC NonUser Comparison
What we learned
Attendance success varied
SBHC Visit Outcome
50%
60%
70%
80%
90%
100%
Year 1 Year 2 Year 3
Returned to Class Dismissed Other
N=3707 N=5080 N=6354
Yearly Absences among Those Reporting ADHD across SBHC Users, Nonusers and
Comparison
5
10
15
20
25
Year 1 Year 2 Year 3
Ave
rage
Abs
ence
s
SBHC User SBHC NonUser Comparison
Note: Statistical 3-way interactionNote: Statistical 3-way interaction
What we learned
Improved access to healthcare
Percent of Parents Reporting Perceived Problems getting
Health Care (N=581)
0
5
10
15
20
25
30
Year 1 Year 2 Year 3
Per
cent
SBHC User SBHC NonUser Comparison
What we learned
Medicaid costs did not increase
Trend of Total Medicaid Costs by SBHC per 100 Students for 22 quarters(N=2153)
0
10000
20000
30000
40000
50000
60000
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Quarter (Sept 1997 - Feb 2003)
Qua
rterly
Tot
al C
ost
TC_NonSBHC TC_SBHC
SBHC
What we learned
Medicaid savings for a rural SBHC
Total Quarterly Medicaid Costs for Rural Schools per 100 Students (N=725)
0
5000
10000
15000
20000
25000
30000
35000
40000
45000
50000
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22
Quarter (Sept 1997 - Feb 2003)
Tot
al Q
uart
lery
Cos
t
TC_NonSBHC_Rural TC_SBHC_Rural
SBHC
What we learned
Closed the gap of healthcare services for African-American students
Growth Trend of Quarterly Total Costs by Race (N=5056)
-12.00 -7.80 -3.60 0.60 4.80 9.00
Total Cost by Race
Quarter (Sept 1997 - Feb 2003)
0.0
43.7
87.3
131.0
174.7
218.4
262.0
305.7
349.4
393.1
436.7
Total Cost
Other RACE = 0
black = 1
Racial Disparity:
African Americans with low costs at the initial point, then, overcame the difference with SBHC.
What we learned
Significant Medicaid savings for
students with asthma
Numbers of Hospitalization and ER Visits for Children with Asthma in SBHC Schools (N=196)
and Non-SBHC Schools (N=77)
36
12
344
307
11 10
200210
0
50
100
150
200
250
300
350
400
Hospital-Before Hospital-After ER-Before ER-After
Before - After SBHC
Hos
pit
aliz
atio
n o
r E
R V
isit
s
SBHC Non-SBHC
With SBHC, hospitalizations decreased 3-fold.
Hospitalization Costs Before and After SBHC for Students with Asthma (N=273)
Estimated Marginal Means of HOSPCOST
TIME
21
Est
ima
ted
Ma
rgin
al M
ea
ns
1400
1200
1000
800
600
400
200
0
SBHC
0
1
Hospitalization costs decreased $970 per student.
SBHC
What we learned
Increased use of mental health services
Medicaid Mental Health Service Costs before and after the SBHC Program for Students with Mental
Health Problems (N=551)
Estimated Marginal Means of MENTCOST
TIME
21
Est
ima
ted
Ma
rgin
al M
ea
ns
4000
3000
2000
1000
SBHC
.00
1.00
Students with mental health illnesses had more mental service costs.
SBHC
For full study results see:
http://www.healthfoundation.org/sbhcstudy.html
Contact:Kate Keller