David Geffen School of Medicine at UCLA, Los Angeles, CA.
The L.A. Trust for Children's Health, Los Angeles, CA.
J Sch Health. 2022 Nov;92(11):1045-1050. doi: 10.1111/josh.13226. Epub 2022 Aug 9.
Little is known regarding utilization of school-based health centers (SBHCs) during prolonged school closures, such as those that occurred during the COVID-19 pandemic. We sought to compare SBHC utilization before and after pandemic-related school closures across a network of SBHCs affiliated with a large Southern Californian urban school district.
We conducted a secondary analysis of encounter data extracted from electronic health records from 12 SBHCs that remained open despite school closures, including patient demographics and diagnostic and billing codes. We used the Clinical Classifications Software Refined to group encounters for common primary care conditions. Utilization before and during pandemic-related school closures was compared using logistic regression with cluster-robust standard errors to account for clustering within clinics, after adjusting for month of encounter.
During the pandemic, study SBHCs conducted 52,530 encounters and maintained ∼4040 encounters/month. The frequency of encounters for annual preventative health exams increased for school-aged patients but decreased for other age groups while the frequency of encounters for mental health problems increased for all age groups.
IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Despite pandemic-related school closures, SBHCs appeared play a critical role in providing primary care to vulnerable communities.
SBHCs may hold value beyond their co-location with academic instruction.
在新冠疫情期间，学校关闭时间较长，人们对学校卫生中心（SBHC）的使用情况知之甚少。我们试图比较在与南加州一个大型城市学区相关联的 SBHC 网络中，在与疫情相关的学校关闭前后 SBHC 的使用情况。
我们对 12 家尽管学校关闭但仍保持开放的 SBHC 电子健康记录中的就诊数据进行了二次分析，这些数据包括患者人口统计学特征以及诊断和计费代码。我们使用经过改良的临床分类软件对常见的初级保健条件进行分组。利用逻辑回归和聚类稳健标准误差比较了与疫情相关的学校关闭前后的就诊情况，以在调整就诊月份后，对诊所内的聚类进行了调整。
在疫情期间，研究中的 SBHC 共进行了 52530 次就诊，每月维持约 4040 次就诊。接受年度预防保健检查的学龄患者就诊频率增加，但其他年龄组的就诊频率下降，而所有年龄组的心理健康问题就诊频率均增加。
对学校卫生政策、实践和公平的启示：尽管与疫情相关的学校关闭，但 SBHC 似乎在为弱势社区提供初级保健方面发挥了关键作用。
SBHC 的价值可能超出了与学术教学的结合。
