Cost-Savings of School-Based Health Centers

Research and evaluations have demonstrated that school-based health centers represent cost-effective investments of public resources:
  • A study by Johns Hopkins University found that school-based health centers reduced inappropriate emergency room use, increased use of primary care, and resulted in fewer hospitalizations among regular users.1
  • A study of Medicaid-enrolled children served by a SBHC in Atlanta, Georgia found significantly lower inpatient, nonemergency department transportation, drug, and emergency department Medicaid expenses as compared to children without a SBHC. In 1996 the total yearly expense per individual for the SBHC was $898.98, as compared to $2360.46 for individuals without a SBHC.2
  • The number of hospitalizations and emergency department visits decreased for children with SBHCs in Cincinnati schools (2.4-fold and 33.5% respectively) – with an estimated savings of nearly $1,000 per child.3
  • Students in New York City schools with SBHCs were less likely to have been hospitalized for asthma at least once in the past year (10.5%) compared to those in schools without SBHCs (17.1%).4
  • In South Carolina, prevention-oriented health care provided in a SBHC decreased emergency department visit rates by 41% to 57% -- 18% greater than the decrease in students who did not use the SBHC.5
  • Adolescents with access to SBHCs in Denver had 38% - 55% fewer after-hours care (emergent or urgent) visits than those without school-based health center access.6
  • Students in Ohio who used an SBHC reported more positive self-perceptions of their health, which correlated with lower Medicaid costs. SBHC patients cost Medicaid an average of $30.40 less than comparable, non-SBHC patients.7
  • A study that explored the cost-benefit of a nationwide SBHC program to manage childhood asthma estimated total savings for opportunity costs of work loss and premature death at $23.13 billion.8
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1. Santelli J, Kouzis A, Newcomer S. School-Based Health Centers and Adolescent Use of Primary Care and Hospital Care. Journal of Adolescent Health. 1996;19:267-275.
2. Adams EK, Johnson V. An Elementary School-Based Health Clinic: Can it Reduce Medicaid Costs? Pediatrics. Apr 2000;105(4 Pt 1):780-788.
3. Guo JJ, Jang R, Keller KN, McCracken AL, Pan W, Cluxton RJ. Impact of School-Based Health Centers on Children with Asthma. Journal of Adolescent Health. Oct 2005;37(4):266-274.
4. Webber MP, Carpiniello KE, Oruwariye T, Lo Y, Burton WB, Appel DK. Burden of Asthma in Inner-City Elementary Schoolchildren: Do School-Based Health Centers Make a Difference? Archives of pediatrics & adolescent medicine. Feb 2003;157(2):125-129.
5. Key JD, Washington EC, Hulsey TC. Reduced Emergency Department Utilization Associated with School-Based Clinic Enrollment. Journal of Adolescent Health. Apr 2002;30(4):273-278.
6. Kaplan D, Calonge B, Guernsey B, Hanrahan M. Managed Care and School-based Health Centers: Use of Health Services. Archives of Pediatric and Adolescent Medicine. 1998;152:25-33.
7. Wade TJ, Guo JJ. Linking Improvements in Health-Related Quality of Life to Reductions in Medicaid Costs Among Students Who Use School-Based Health Centers. American journal of public health. Sep 2010;100(9):1611-1616.
8. Tai T, Bame SI. Cost-Benefit Analysis of Childhood Asthma Management Through School-Based Clinic Programs. J Community Health. Apr 2011;36(2):253-260.

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