title: Linking improvements in health-related quality of life to reductions in Medicaid costs among students who use school-based health centers.
abstract: OBJECTIVE
  We examined whether improvements in pediatric health-related quality of life (HRQOL) stemming from use of school-based health centers (SBHCs) resulted in lower Medicaid costs.
  
  
  METHODS
  We analyzed data on 290 students from a 3-year, longitudinal SBHC evaluation conducted in Cincinnati, Ohio, in 2000 to 2003, including 71 with a mental health diagnosis and 31 with asthma, who had linked Ohio Medicaid records. HRQOL was measured using the Pediatric Quality of Life Inventory. Panel regression examined whether changes in parent-reported and student self-reported HRQOL predicted changes in Medicaid costs.
  
  
  RESULTS
  After adjustment for gender, age, SBHC status, and Medicaid type, we found cost reductions for every 1-point increase of parent-reported total ($36.39; P<.01), physical ($35.36; P<.05), and psychosocial ($25.94; P<.01) HRQOL. Significant cost reductions were also associated with student-reported total ($8.94; P<.05) and psychosocial ($7.79; P<.05) HRQOL increases. These effects were significant among the asthma subgroup but not the mental health subgroup. Physical HRQOL ($6.12; P=.27) effects were not significant.
  
  
  CONCLUSIONS
  Improvements in pediatric HRQOL translate into lower Medicaid costs, supporting the use of HRQOL as an outcome for evaluating SBHCs.
authors.affiliation: Department of Community Health Sciences, Brock University, 500 Glenridge Ave, St Catharines, Ontario, Canada, L2S 3A1. twade@brocku.ca
authors.forename: Terrance J
authors.initials: TJ
authors.lastname: Wade
authors.forename: Jeff Jianfei
authors.initials: JJ
authors.lastname: Guo
mesh_terms: D000293:Adolescent; D002648:Child; D003362:Cost-Benefit Analysis; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D007629:Kentucky; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid / Q000191:economics*; D008605:Mental Health Services / Q000706:statistics & numerical data; D009820:Ohio; D011788:Quality of Life; D012044:Regression Analysis; D012572:School Health Services / Q000706:statistics & numerical data*; D014481:United States