title: School-based health centers: cost-benefit analysis and impact on health care disparities.
abstract: OBJECTIVE
  We evaluated the impact of school-based health centers-which provide essential health care for students by aiming to eliminate many access barriers-on health care access disparities and conducted a cost-benefit analysis.
  
  
  METHODS
  We employed a longitudinal quasi-experimental repeated-measures design. Primary data sources included the Ohio Medicaid claims, enrollment file with race/ethnicity, and survey reports from parents. We used hierarchical linear modeling to control unbalanced data because of student attrition. We assessed quarterly total Medicaid reimbursement costs for 5056 students in the SBHC and non-SBHC groups from 1997 to 2003. We calculated net social benefit to compare the cost of the SBHC programs with the value that SBHCs might save or create.
  
  
  RESULTS
  With SBHCs, the gap of lower health care cost for African Americans was closed. The net social benefits of the SBHC program in 4 school districts were estimated as $1,352,087 over 3 years. We estimated that the SBHCs could have saved Medicaid about $35 per student per year.
  
  
  CONCLUSIONS
  SBHCs are cost beneficial to both the Medicaid system and society, and may close health care disparity gaps.
authors.affiliation: University of Cincinnati Medical Center College of Pharmacy, 3225 Eden Ave, Cincinnati, OH 45267-0004, USA. jeff.guo@uc.edu
authors.forename: Jeff J
authors.initials: JJ
authors.lastname: Guo
authors.forename: Terrance J
authors.initials: TJ
authors.lastname: Wade
authors.forename: Wei
authors.initials: W
authors.lastname: Pan
authors.forename: Kathryn N
authors.initials: KN
authors.lastname: Keller
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D006297:Health Services Accessibility; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008484:Medicaid / Q000191:economics*; D009820:Ohio; D012572:School Health Services / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States