Crespo R D, Shaler G A
Department of Family and Community Health, Marshall University School of Medicine, Huntington, West Virginia, USA.
J Adolesc Health. 2000 Mar;26(3):187-93. doi: 10.1016/s1054-139x(99)00053-1.
To assess the capability of school-based health centers (SBHCs) to provide access to health care for rural youth.
Review of annual patient records from SBHCs in West Virginia. Ten of 24 SBHCs in West Virginia in operation from July 1994 to June 1997 were selected for the study. Enrollment and utilization rates were generated for each site. A comparison was made between rates of enrollment, utilization, and annual visits among youth with private insurance, those covered by Medicaid, and youth without insurance. Rural and urban SBHCs within West Virginia were compared based on enrollment, utilization, and visit rates. The diagnostic categories were analyzed. Finally, enrollment rates, utilization rates, and insurance status for the West Virginia SBHCs were compared with national norms.
Enrollment rates rose steadily during the study period from 27% in Year 1 to 64% by the end of Year 3. The utilization rate was 67% in Year 3. The youth with either Medicaid or no insurance comprised 52% of enrollees, but they accounted for 63% of all visits. West Virginia SBHCs have a higher rate of Medicaid users than the national average for SBHCs, and the annual visit rate for West Virginia youth is higher than the national average for nonmetropolitan adolescents. The enrollment rate of 64% is slightly higher than the national average for SBHCs. Within West Virginia, the enrollment rate in rural schools was significantly higher, 86% compared to 46% (p < .001), and the utilization rate was 70% in rural centers compared to 63% in the urban centers (p < .001).
When SBHCs are available in rural areas, students use them. In West Virginia, SBHCs have contributed to providing access to health care for rural youth.
评估校内健康中心（SBHCs）为农村青少年提供医疗服务的能力。
回顾西弗吉尼亚州SBHCs的年度患者记录。选取了1994年7月至1997年6月运营的西弗吉尼亚州24家SBHCs中的10家进行研究。计算每个地点的注册率和使用率。比较了有私人保险的青少年、医疗补助覆盖的青少年和无保险青少年的注册率、使用率和年度就诊率。根据注册率、使用率和就诊率对西弗吉尼亚州的农村和城市SBHCs进行了比较。对诊断类别进行了分析。最后，将西弗吉尼亚州SBHCs的注册率、使用率和保险状况与全国标准进行了比较。
在研究期间，注册率从第1年的27%稳步上升至第3年末的64%。第3年的使用率为67%。有医疗补助或无保险的青少年占注册者的52%，但占所有就诊人数的63%。西弗吉尼亚州SBHCs的医疗补助使用者比例高于SBHCs的全国平均水平，西弗吉尼亚州青少年的年度就诊率高于非大都市青少年的全国平均水平。64%的注册率略高于SBHCs的全国平均水平。在西弗吉尼亚州内，农村学校的注册率显著更高，为86%，而城市学校为46%（p < .001），农村中心的使用率为70%，而城市中心为63%（p < .001）。
当农村地区设有SBHCs时，学生会使用它们。在西弗吉尼亚州，SBHCs有助于为农村青少年提供医疗服务。
