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School-Based Health Centers and the Utilization of Primary Care in Rural Communities
Xue Zhang1, Sharon Tennyson2, Chris Kjolhede3
1Department of Biobehavioral Health, Penn State University, University Park, Pennsylvania.
American Journal of Preventive Medicine
|June 30, 2025
Summary
School-based health centers (SBHCs) in rural areas increased primary care visits and immunizations for students. Utilization varied, with hybrid users showing the highest engagement and benefits.
Area of Science:
- Public Health
- Pediatrics
- Healthcare Access
Background:
- School-based health centers (SBHCs) are crucial for rural students' primary care access.
- Limited evidence exists on SBHC service utilization patterns in these communities.
Purpose of the Study:
- To analyze primary care utilization patterns among students with and without access to SBHCs.
- To compare utilization among different SBHC user groups (non-users, SBHC-only, hybrid).
Main Methods:
- Analysis of 2011-2017 electronic health record data for students aged 5-18 in rural New York.
- Categorization of students based on SBHC access and usage (non-users, SBHC-only, hybrid users).
- Statistical analysis adjusting for demographic and socioeconomic factors.
Main Results:
- Students with SBHC access showed greater primary care utilization than those without.
- Hybrid users exhibited the highest utilization, while SBHC-non-users had the lowest.
- SBHC-only users had increased office visits and immunizations compared to students without SBHC access.
Conclusions:
- SBHCs significantly increase office visits and immunizations for rural students utilizing primary care.
- Promoting SBHC enrollment and usage is vital, as benefits are concentrated among users.
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