Reduced emergency department utilization associated with school-based clinic enrollment

Purpose: To evaluate the change in emergency department utilization before and after enrollment in a school-based clinic (SBC). Methods: This study was a retrospective cohort study comparing emergency department visit rate before and after SBC enrollment based on chart review. An initial cohort of 10- to 15-year-olds who used a local emergency department was divided into two samples: those who had been enrolled in the SBC and those who had not. Emergency department charts were reviewed for visits that occurred during the initial year and two subsequent school years. The change in visit rate for each sample group was measured for each school year evaluated. Results: The initial cohort consisted of 2852 youth, 344 of whom who lived in the high school attendance zone. Of these, the number of students enrolled in both the high school and the SBC was 43; the number enrolled in the high school but not in the clinic was 48. The emergency department visit rate decreased for both groups for each school year evaluated; however, this decrease was significant only for the SBC sample with a 41% to 57% decrease in emergency department utilization, 18% greater than the decrease in students who did not use the SBC. Conclusions: Accessible, prevention-oriented health care provided in a SBC can decrease the utilization of episodic health care in an emergency department. (C) Society for Adolescent Medicine, 2002.