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Results show on-site clinics lower school district care costs

Aug. 9, 2018, 10:43 AM

 

Onsite health clinics that provide primary care to teachers and their families can lower a school district’s health care costs, according to a new study that found these outcomes at Vanderbilt’s nurse-managed clinics at Metro Nashville Public Schools (MNPS).

The study from the nonprofit RAND Corporation found that teachers who used onsite health clinics as the source of primary care cut their annual health costs by about 15 percent and were significantly less likely to be admitted to the hospital.

The study is the largest to date to examine the benefits of opening onsite health clinics for workers and is the first to examine worksite clinics for teachers. The findings were published online by the Journal of Occupational and Environmental Medicine.

“Our findings suggest opening onsite health clinics may be one promising action that school organizations can take to help lower their health care costs,” said Harry Liu, the study’s senior author and a policy researcher at RAND Corporation.

Researchers analyzed the impact of the Vanderbilt clinics, which began with five locations in 2009 and serve 120 schools, nearly 6,000 teachers and more than 80,000 students, the study says. The system was designed so every teacher can reach a worksite clinic within a 15-minute drive from the school where they work. Family nurse practitioners manage and staff the clinics and provide care to all teachers and their dependents. Vanderbilt University School of Nursing (VUSN) provides the faculty for the clinics and operates them in partnership with Vanderbilt University Medical Center.

No copayments are charged for worksite clinic visits and teachers can get same-day appointments with little wait in most cases, the study says. In addition to offering convenient primary care at or near the workplace, the clinics offer patients health management programs for diabetes, cardiovascular diseases, respiratory conditions and overweight or obesity.

The study found that teachers who have a school-based primary care provider have significantly fewer inpatient admissions and primary care visits than peers who use a community-based primary care provider. As a result, school-based primary care providers served patients at a significantly lower annual health care cost — $745 less per person. Other results indicated that the school-based clinics reduced teacher absenteeism.

Pam Jones, DNP, senior associate dean for Clinical and Community Partnerships for the School of Nursing, oversees the VUSN faculty-run clinics.

“The findings from this study underscore the importance of this innovative partnership with Metro Nashville Public Schools. This project is promising as a model for effective population health.”

“It is great to have data to prove onsite health care clinics are helping decrease costs for MNPS health care and, more important, are helping to improve the health of the teachers and therefore improve teachers’ effectiveness,” said Patti McCarver, DNP, FNP-BC, senior project manager in VUMC’s Office of Population Health and an author of the study.

The other authors of the study are John Engberg of RAND; Jon Harris-Shapiro of Continuance Health Solutions Inc. and David Hines of MNPS.

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