scholarly journals The Use of Telehealth in School-Based Health Centers

2019 ◽  
Vol 6 ◽  
pp. 2333794X1988419 ◽  
Author(s):  
Hayley Love ◽  
Nirmita Panchal ◽  
John Schlitt ◽  
Caroline Behr ◽  
Samira Soleimanpour
Keyword(s):  
United States ◽  
Health Care ◽  
Public Schools ◽  
Health Care Access ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Centers ◽  
School Based ◽  
School Based Health Centers

Telehealth is a growing model of delivering health care. School-based health centers (SBHCs) provide access to health care for youth in schools and increasingly use telehealth in care delivery. This article examines the recent growth of telehealth use in SBHCs, and characteristics of SBHCs using telehealth, including provider types, operational characteristics, and schools and students served. The percentage of SBHCs using telehealth grew from 7% in 2007-2008 to 19% in 2016-2017. Over 1 million students in over 1800 public schools have access to an SBHC using telehealth, which represents 2% of students and nearly 2% of public schools in the United States. These SBHCs are primarily in rural communities and sponsored by hospitals. This growing model presents an opportunity to expand health care access to youth, particularly in underserved areas in the United States and globally. Further research is needed to fully describe how telehealth programs are implemented in school settings and their potential impacts.

Nurse Practitioner’s Ethical and Legal Dilemma: Caring for a Young Child Without a Parent in the School-Based Health Center Setting

2009 ◽  
Vol 2 (1) ◽  
pp. 19-22
Author(s):  
Mary Huang
Keyword(s):  
Health Care ◽  
Young Child ◽  
Nurse Practitioners ◽  
Access To Health Care ◽  
School Setting ◽  
Young Patients ◽  
The United States ◽  
Health Centers ◽  
School Based ◽  
School Based Health Centers

Since the 1980s, the number of school-based health centers has increased due to funding that lead to recognition by policy makers and health organizations. The mission was to provide comprehensive pediatric health care to children with limited access to health care and the uninsured. The goal was to decrease school absenteeism and missed work days by providing convenient primary and acute care while children are in school. For sponsoring organizations managing school-based clinics, allowing parents to be absent during clinic visits met its mission. However, the ease of young children receiving health care in the school setting without being accompanied by their parents has positioned nurse practitioners in an ethical and legal dilemma. Asking a young child significant health history during a physical examination or having them describe their chief complaints during an acute visit may not be the best way to provide good care to our young patients. Additionally, what are the legal responsibilities of a nurse practitioner when caring for a child without active participation of the parent? Little has been documented in the past about the dilemmas nurse practitioners face in school clinic settings. With increasing use and recognition of school-based health centers in the United States, the need for more discussion is required to explore solutions to provide quality comprehensive care for patients and their families.

‘How come they don’t talk about it in school?’ Identifying adolescent barriers to PrEP use

2021 ◽  
Author(s):  
Leslie Gailloud ◽  
Tatiana Gonzalez-Argoti ◽  
Sophia Philip ◽  
Lena S Josephs ◽  
Joanne E Mantell ◽  
...  
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Thematic Analysis ◽  
The United States ◽  
Health Centers ◽  
Perceived Need ◽  
School Based ◽  
Immunodeficiency Virus ◽  
School Based Health Centers ◽  
Exposure Prophylaxis

Abstract Although 21% of new human immunodeficiency virus (HIV) diagnoses in the United States are in youth aged 13–24 years, adolescent awareness and uptake of the HIV prevention medication pre-exposure prophylaxis (PrEP) are low. This study explores the attitudes and challenges that adolescents face while taking PrEP. Thirty interviews were conducted with Black and Latine (we use the gender-inclusive term Latine rather than Latinx for more appropriate Spanish pronunciation) students aged 15–17 who received care at school-based health centers (SBHCs) in the Bronx, NY. Transcripts were coded inductively and deductively using thematic analysis. Most participants were unaware of PrEP, but nearly all were enthusiastic when informed about it; a majority denied that they would feel any stigma when taking PrEP. Despite this high receptivity, multiple barriers were identified, particularly confidentiality from parents, low perceived need of PrEP and concerns about daily adherence and side effects. Adolescents overall were enthusiastic about the availability of PrEP and felt it empowered them to have control over their health. SBHCs were considered trusted sources of confidential, accessible care, and we believe that they can be uniquely positioned to mitigate barriers to PrEP distribution in the future.

scholarly journals The Implementation and Evaluation of the United States Affordable Care Act

2019 ◽  
Vol 12 (1) ◽  
pp. 17-38
Author(s):  
David Schultz
Keyword(s):  
United States ◽  
Health Care ◽  
Affordable Care Act ◽  
Access To Health Care ◽  
Care Delivery ◽  
The United States ◽  
Health Care Delivery System ◽  
Health Care Outcomes ◽  
The Us ◽  
American Health Care

In 2010 the United States Congress adopted the Patient Protection and Affordable Care Act (“ACA”), more commonly referred to as Obamacare. The ACA was proposed by President Barack Obama while running for president and it was passed with a near straight party-line vote of Democrats in the US House and Senate in 2010. The ACA was meant to address several problems with the American health care delivery system, including cost, access and outcomes. This article describes the major features of the ACA including the context of the US health care system, evaluates the ACA’s implementation history and assesses its fate and future reforms throughout the presidency of Donald Trump. The overall conclusion based on its implementation is that while the ACA made significant reforms in terms of access to health care, it is not clear that it addressed affordability or began to improve health care outcomes in the US.

scholarly journals The Evidence on School-Based Health Centers: A Review

2019 ◽  
Vol 6 ◽  
pp. 2333794X1982874 ◽  
Author(s):  
Michael Arenson ◽  
Philip J. Hudson ◽  
NaeHyung Lee ◽  
Betty Lai
Keyword(s):  
Health Equity ◽  
Care Delivery ◽  
Evidence Synthesis ◽  
Opportunity To Learn ◽  
The United States ◽  
Health Centers ◽  
Access To Health Services ◽  
Dual Roles ◽  
School Based ◽  
School Based Health Centers

Context. Pediatricians working toward health equity require health care delivery mechanisms that take on dual roles: mitigating the health effects of a maladaptive social ecosystem while simultaneously working to improve the ecosystem itself. School-based health centers (SBHCs) perform these dual roles by providing medical, mental/behavioral, dental, and vision care directly in schools where young people spend the majority of their time, maximizing their opportunity to learn and grow. Evidence Acquisition. Databases were searched extensively for research studies published between January 2000 and December 2018. Evidence Synthesis. The authors began with 3 recent high-impact reviews that covered SBHC history, health outcomes, cost-benefit, and impact on health equity. Informed by these articles, the authors organized the evidence into 4 broad categories of impact: Financial, Physical Health (including medical, vision, and dental), Mental Health, and Educational Outcomes. Using these 4 categories, the authors then performed a robust literature search using PubMed for studies that fit into these themes. Conclusions. SBHCs increase access to health services for children, families, and communities, which ultimately leads to positive short- and long-term outcomes in service of a broad range of stakeholders. Educational impact requires further attention on both outcomes and methodological approaches. Three current public health topics of importance were identified that SBHCs might be well-suited to address: Youth Gun Violence, Adverse Childhood Experiences, and the Health of American Indian/Alaskan Native communities in the United States.

Health Care in the United States: Access, Costs, and Quality

1987 ◽  
Vol 20 (02) ◽  
pp. 197-201
Author(s):  
John F. Hoadley
Keyword(s):  
United States ◽  
Health Care ◽  
Medical Care ◽  
Health Care Delivery ◽  
Cost Containment ◽  
Access To Health Care ◽  
Health Care Cost ◽  
Care Delivery ◽  
The United States ◽  
Political Issue

Fact: As a nation, medical care expenditures represent 10.6% of the gross national product. The portion of the nation's medical care dollar coming from federal sources declined slightly (42.6% to 41.4%) between 1981 and 1984, but this share is more than 15 percentage points above the comparable figure from the years prior to 1965 (Anderson, 1985).As these numbers illustrate, paying for health care is a very expensive proposition in the United States, consuming a higher proportion of our nation's resources than is true for most developed nations. While we have strongly resisted any move to a government-run system of health care delivery, the above numbers also show clearly that the federal government pays for a substantial share of all health care in this country.Three major themes have dominated the health policy agenda during recent years: access to health care, cost containment, and quality of care. The fates of these issues have waxed and waned over the years as changes in health care delivery, federal budgetary politics, and shifting public opinion have altered the environment over time. In the 1960s, access was the key issue, as Democratic administrations used government programs to make health care more readily available to all Americans. As inflation levels soared in the 1970s, cost containment was forced onto the agenda, resulting in a series of attempts to reduce federal expenditures on hospital care. Finally, by the mid-1980s, cost containment pressures were modifying slightly; we have recently witnessed a return to access issues and the emergence of quality as a new political issue.

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