Role of school-based health centers in referral completion

• Published in: Journal of adolescent health 1997-11, Vol.21 (5), p.328-334
• Main Authors: Hacker, Karen A., Weintraub, Toni Abrams, Fried, Lise E., Ashba, Jacqueline
• Format: Article
• Language: English
• Subjects: Adolescent; Adolescent Health Services; Biological and medical sciences; Boston; Chi-Square Distribution; Continuity of Patient Care; Coordinating care; Female; Hospitals; Humans; Male; Medical sciences; Patient Compliance; Prevention and actions; Public health. Hygiene; Public health. Hygiene-occupational medicine; Referral and Consultation - organization & administration; Referral and Consultation - statistics & numerical data; Referral completion; Referrals; Retrospective Studies; School Health Services - organization & administration; School-based health centers; Specific populations (family, woman, child, elderly...); Student health services; USA; Young people
• ISSN: 1054-139X; 1879-1972
• DOI: 10.1016/S1054-139X(97)00045-1

This study examined referrals from School-based health centers (SBHCs) to a sponsoring hospital to determine factors influencing successful referral completion and to assess SBHCs' ability to coordinate care. A total of 138 referrals from eight SBHCs to Boston City Hospital between September 1993 and October 1994 were reviewed via medical records, clinic logs, and hospital registration system. A data extraction tool was used to collect information. Statistical analyses were performed to identify associations between referral completion and study variables. Seventy-five percent of all referrals were completed: 55.4% on the first attempt. Forty-six percent of those referred a second time completed their referrals. Statistically significant associations between referral completion and reason for referral ( p = 0.01), visit diagnosis ( p = 0.005), and usual source of health care ( p = 0.009) were found. Provider documentation, including referral log and patient chart, was also associated with referral completion. Neither gender, race, nor health insurance had any significant association with successful referrals. This study suggests that SBHCs can significantly contribute to coordinated care for adolescents, especially for the uninsured and those without a source of health care. SBHCs were particularly effective at facilitating referral to specific services including: family planning, tuberculosis prophylaxis, and subspecialty care. Provider action, such as making appointments and documentation, was also an important factor.