Impact of Rural School-Based Health Centers on Asthma Management

Area of Science:

• Public Health
• Pediatric Healthcare
• Asthma Management

Background:

• School-based health centers (SBHCs) can improve healthcare access for students.
• Asthma is a common chronic condition affecting school-aged children.
• Rural students often face barriers to accessing consistent healthcare.

Purpose of the Study:

• To evaluate the impact of SBHC access on healthcare utilization for rural students with asthma.
• To test if SBHC access leads to increased preventive care and decreased emergency care for pediatric asthma patients.

Main Methods:

• Cross-sectional study analyzing healthcare encounters for students aged 4-19 in rural upstate New York.
• Geocoding of patient addresses to school districts to determine SBHC access (15 districts with SBHCs, 23 without).
• Comparison of asthma-related office visits, well-child visits, and emergency/convenient care visits between students with and without SBHC access.

Main Results:

• Students in districts with SBHCs had higher odds of receiving 2+ asthma office visits (OR=2.23) and 1+ well-child visit (OR=1.24).
• Students with SBHC access showed lower odds of respiratory-related convenient care or emergency department visits (OR=0.45).
• The greatest differences in utilization were observed when comparing students using SBHCs with those in districts lacking SBHC access.

Conclusions:

• Access to SBHCs is associated with increased adherence to national guidelines for preventive asthma care among rural students.
• SBHCs appear to reduce the reliance on emergency departments and convenient care for asthma management in this population.
• SBHCs represent a valuable resource for improving asthma care delivery in rural school settings.