Frequent school-based clinic utilization: a comparative profile of problems and service needs

The purpose of this study is to compare frequent users of school-based clinic services with students who have an average rate of utilization.

Of the 1413 students enrolled in a Denver school-based clinic (DSBC) during the 1989-1990 school year, frequent clinic users (n = 73) were defined as those who visited the clinic 15 times or more (range, 15-72 visits per year). Average users (n = 82) were defined as students who visited the clinic three times during the year (the mean and median number of visits per student enrolled). Average users were compared.

The average utilizers were found to be representative of the entire student population based on age, race, gender, and grade. The frequent users had more females (71%) and a lower grade point average (GPA) (2.11) than the average users (52% female, 2.54 GPA; p < 0.02). The frequent clinic users differed in their initial primary diagnoses as well as in the types of subsequent visits, having a significantly higher percentage of mental health-related visits than did the average users (61% versus 10%; p < 0.01). The frequent clinic users also demonstrated more high-risk behaviors such as alcohol use, sexual activity, and both family and peer relationships (p < 0.001).

These data suggest that frequent clinic users have significant health needs that may require a higher rate of utilization.