Bezem Janine, Heinen Debbie, Reis Ria, Buitendijk Simone E, Numans Mattijs E, Kocken Paul L
Department of Preventive Youth Health Care, Municipal Health Service Gelderland-Midden, P.O. Box 5364, 6802, EJ, Arnhem, The Netherlands.
Department of Child Health, TNO, P.O. Box 3005, 2301, DA, Leiden, The Netherlands.
BMC Health Serv Res. 2017 Nov 17;17(1):743. doi: 10.1186/s12913-017-2711-4.
The organisation of health assessments by preventive health services focusing on children's health and educational performance needs to be improved due to evolving health priorities such as mental health problems, reduced budgets and shortages of physicians and nurses. We studied the impact on the school professionals' perception of access to school health services (SHS) when a triage approach was used for population-based health assessments in primary schools. The triage approach involves pre-assessments by SHS assistants, with only those children in need of follow-up being assessed by a physician or nurse. The triage approach was compared with the usual approach in which all children are assessed by physicians and nurses.
We conducted a cross-sectional study, comparing school professionals' perceptions of the triage and the usual approach to SHS. The randomly selected school professionals completed digital questionnaires about contact frequency, the approachability of SHS and the appropriateness of support from SHS. School care coordinators and teachers were invited to participate in the study, resulting in a response of 444 (35.7%) professionals from schools working with the triage approach and 320 (44.6%) professionals working with the usual approach.
Respondents from schools using the triage approach had more contacts with SHS and were more satisfied with the appropriateness of support from SHS than respondents in the approach-as-usual group. No significant differences were found between the two groups in terms of the perceived approachability of SHS.
School professionals were more positive about access to SHS when a triage approach to routine assessments was in place than when the usual approach was used. Countries with similar population-based SHS systems could benefit from a triage approach which gives physicians and nurses more opportunities to attend schools for consultations and assessments of children on demand.
由于心理健康问题、预算削减以及医生和护士短缺等不断变化的健康优先事项，专注于儿童健康和教育表现的预防性健康服务所开展的健康评估组织工作需要改进。我们研究了在小学进行基于人群的健康评估时采用分诊方法对学校专业人员对获得学校健康服务（SHS）的看法的影响。分诊方法包括由SHS助理进行预评估，只有那些需要后续跟进的儿童才由医生或护士进行评估。将分诊方法与所有儿童均由医生和护士进行评估的常规方法进行了比较。
我们进行了一项横断面研究，比较学校专业人员对分诊方法和SHS常规方法的看法。随机选择的学校专业人员完成了关于接触频率、SHS的可及性以及SHS支持的适当性的数字问卷。邀请了学校护理协调员和教师参与研究，结果有444名（35.7%）采用分诊方法的学校专业人员和320名（44.6%）采用常规方法的专业人员做出了回应。
与常规方法组的受访者相比，采用分诊方法的学校的受访者与SHS的接触更多，并且对SHS支持的适当性更满意。在SHS的可及性感知方面，两组之间未发现显著差异。
与采用常规方法时相比，当采用分诊方法进行常规评估时，学校专业人员对获得SHS的态度更为积极。具有类似基于人群的SHS系统的国家可以从分诊方法中受益，该方法使医生和护士有更多机会应要求到学校为儿童进行咨询和评估。
