School health screening: costs, benefits and alternatives.
The Chicago Board of Education's requirement of periodic physical examinations for school attendance provides an excellent opportunity to review the costs and benefits of routine well child care. While working with the National Health Service Corps as a family practitioner at the Uptown People's Health Center in Chicago, Dr. Sweeney conducted a study based on the situation created by the Board's requirement. Seven hundred and fifty children from a high risk neighborhood obtained free examinations, offered by the Uptown Center, to satisfy no other complaint than the request for a "school physical." The exams were performed by two family physicians, two pediatricians, three internists and two physician assistants, as well as a dental hygienist. Included in each exam were routine history and physical, Hgb, urinalysis, sickle cell prep (where indicated) and dental inspection. Abnormalities which required follow-up were identified in three-fourths of the children. Two-thirds of these returned for at least one subsequent check. Here, the results of this mass screening are presented. The cost and benefit of this approach is discussed. An alternative is suggested to maximize the rates of detection and the effectiveness of follow-up on significant identifiable conditions.
D002641:Chicago; D002648:Child; D003151:Community Health Centers; D003362:Cost-Benefit Analysis; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D010808:Physical Examination; D012572:School Health Services / Q000639:trends*