title: Key factors for providing appropriate medical care in secondary school athletics: athletic training services and budget.
abstract: BACKGROUND
  Research suggests that appropriate medical care for interscholastic athletes is frequently lacking. However, few investigators have examined factors related to care.
  
  
  OBJECTIVE
  To examine medical care provided by interscholastic athletics programs and to identify factors associated with variations in provision of care.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Mailed and e-mailed survey.
  
  
  METHODS
  One hundred sixty-six South Carolina high schools.
  
  
  METHODS
  The 132-item Appropriate Medical Care Assessment Tool (AMCAT) was developed and pilot tested. It included 119 items assessing medical care based on the Appropriate Medical Care for Secondary School-Age Athletes (AMCSSAA) Consensus Statement and Monograph (test-retest reliability: r = 0.89). Also included were items assessing potential influences on medical care. Presence, source, and number of athletic trainers; school size; distance to nearest medical center; public or private status; sports medicine supply budget; and varsity football regional championships served as explanatory variables, whereas the school setting, region of state, and rate of free or reduced lunch qualifiers served as control variables.
  
  
  METHODS
  The Appropriate Care Index (ACI) score from the AMCAT provided a quantitative measure of medical care and served as the response variable. The ACI score was determined based on a school's response to items relating to AMCSSAA guidelines.
  
  
  RESULTS
  Regression analysis revealed associations with ACI score for athletic training services and sports medicine supply budget (both P < .001) when controlling for the setting, region, and rate of free or reduced lunch qualifiers. These 2 variables accounted for 30% of the variance in ACI score (R(2) = 0.302). Post hoc analysis showed differences between ACI score based on the source of the athletic trainer and the size of the sports medicine supply budget.
  
  
  CONCLUSIONS
  The AMCAT offers an evaluation of medical care provided by interscholastic athletics programs. In South Carolina schools, athletic training services and the sports medicine supply budget were associated with higher levels of medical care. These results offer guidance for improving the medical care provided for interscholastic athletes.
authors.affiliation: University of South Carolina, Columbia, SC, USA. gwham@lexington1.net
authors.forename: George S
authors.initials: GS
authors.lastname: Wham
authors.forename: Ruth
authors.initials: R
authors.lastname: Saunders
authors.forename: James
authors.initials: J
authors.lastname: Mensch
mesh_terms: D002017:Budgets; D003430:Cross-Sectional Studies; D003625:Data Collection; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D010865:Pilot Projects; D012572:School Health Services / Q000191:economics* / Q000458:organization & administration; D012574:Schools / Q000191:economics*; D013022:South Carolina; D013177:Sports / Q000191:economics*; D013178:Sports Medicine / Q000191:economics* / Q000458:organization & administration; D018709:Statistics, Nonparametric