healthcare + education = healthy communities: why schools fit the equation
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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 PresentationTRANSCRIPT
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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
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Healthcare + Education = Healthy Communities: Why
Schools Fit the Equation
Kate Keller, MPASenior Program Officer
The Health Foundation of Greater Cincinnati
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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
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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
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What we learned
Improved Health Status
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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
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What we learned
Improved mental health status
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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
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What we learned
Attendance success varied
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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
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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
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What we learned
Improved access to healthcare
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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
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What we learned
Medicaid costs did not increase
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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
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What we learned
Medicaid savings for a rural SBHC
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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
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What we learned
Closed the gap of healthcare services for African-American students
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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.
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What we learned
Significant Medicaid savings for
students with asthma
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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.
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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
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What we learned
Increased use of mental health services
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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
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For full study results see:
http://www.healthfoundation.org/sbhcstudy.html
Contact:Kate Keller
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