title: School nurses' role in asthma management, school absenteeism, and cost savings: a demonstration project.
abstract: BACKGROUND
  With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding.
  
  
  METHODS
  Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489).
  
  
  RESULTS
  Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant.
  
  
  CONCLUSIONS
  Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs.
authors.affiliation: Associate Professor (of Teaching), (er23@stanford.edu), Department of Pediatrics, Stanford University, 1215 Welch Road, Modular G, Stanford, CA 94305.
authors.forename: Eunice
authors.initials: E
authors.lastname: Rodriguez
authors.forename: Diana Austria
authors.initials: DA
authors.lastname: Rivera
authors.forename: Daniella
authors.initials: D
authors.lastname: Perlroth
authors.forename: Edmund
authors.initials: E
authors.lastname: Becker
authors.forename: Nancy Ewen
authors.initials: NE
authors.lastname: Wang
authors.forename: Melinda
authors.initials: M
authors.lastname: Landau
mesh_terms: D000041:Absenteeism; D000293:Adolescent; D001249:Asthma / Q000628:therapy*; D002140:California; D002648:Child; D003365:Costs and Cost Analysis; D019468:Disease Management; D004636:Emergency Service, Hospital / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D012572:School Health Services / Q000458:organization & administration*; D012573:School Nursing / Q000458:organization & administration*; D012959:Socioeconomic Factors
keywords: asthma; chronic disease; cost savings; school absenteeism; school nurse