Skip to main content
Top
Published in: BMC Health Services Research 1/2017

Open Access 01-12-2017 | Research article

Improving access to school health services as perceived by school professionals

Authors: Janine Bezem, Debbie Heinen, Ria Reis, Simone E. Buitendijk, Mattijs E. Numans, Paul L. Kocken

Published in: BMC Health Services Research | Issue 1/2017

Login to get access

Abstract

Background

The organisation of health assessments by preventive health services focusing on children’s health and educational performance needs to be improved due to evolving health priorities such as mental health problems, reduced budgets and shortages of physicians and nurses. We studied the impact on the school professionals’ perception of access to school health services (SHS) when a triage approach was used for population-based health assessments in primary schools. The triage approach involves pre-assessments by SHS assistants, with only those children in need of follow-up being assessed by a physician or nurse. The triage approach was compared with the usual approach in which all children are assessed by physicians and nurses.

Methods

We conducted a cross-sectional study, comparing school professionals’ perceptions of the triage and the usual approach to SHS. The randomly selected school professionals completed digital questionnaires about contact frequency, the approachability of SHS and the appropriateness of support from SHS. School care coordinators and teachers were invited to participate in the study, resulting in a response of 444 (35.7%) professionals from schools working with the triage approach and 320 (44.6%) professionals working with the usual approach.

Results

Respondents from schools using the triage approach had more contacts with SHS and were more satisfied with the appropriateness of support from SHS than respondents in the approach-as-usual group. No significant differences were found between the two groups in terms of the perceived approachability of SHS.

Conclusions

School professionals were more positive about access to SHS when a triage approach to routine assessments was in place than when the usual approach was used. Countries with similar population-based SHS systems could benefit from a triage approach which gives physicians and nurses more opportunities to attend schools for consultations and assessments of children on demand.
Appendix
Available only for authorised users
Literature
1.
go back to reference Allensworth DD, Kolbe LJ. The comprehensive school health program: exploring an expanded concept. J School Health. 1987;57(10):409–12.CrossRefPubMed Allensworth DD, Kolbe LJ. The comprehensive school health program: exploring an expanded concept. J School Health. 1987;57(10):409–12.CrossRefPubMed
2.
go back to reference Taras H, Potts-Datema W. Chronic health conditions and student performance at school. J School Health. 2005;75(7):255–66.CrossRefPubMed Taras H, Potts-Datema W. Chronic health conditions and student performance at school. J School Health. 2005;75(7):255–66.CrossRefPubMed
3.
go back to reference Allensworth DD, Bradley B. Guidelines for adolescent preventive services: a role for the school nurse. J School Health. 1996;66(8):281–5.CrossRefPubMed Allensworth DD, Bradley B. Guidelines for adolescent preventive services: a role for the school nurse. J School Health. 1996;66(8):281–5.CrossRefPubMed
4.
go back to reference Baltag V, Pachyna A, Hall J. Global overview of school health services: data from 102 countries. Health Behav Policy Rev. 2015;2(4):268–83.CrossRef Baltag V, Pachyna A, Hall J. Global overview of school health services: data from 102 countries. Health Behav Policy Rev. 2015;2(4):268–83.CrossRef
5.
go back to reference Hacker K, Wessel GL. School-based health centers and school nurses: cementing the collaboration. J School Health. 1998;68(10):409–14.CrossRefPubMed Hacker K, Wessel GL. School-based health centers and school nurses: cementing the collaboration. J School Health. 1998;68(10):409–14.CrossRefPubMed
6.
go back to reference Valentijn PP, Schepman SM, Opheij W, Bruijnzeels MA. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care. 2013;13 Valentijn PP, Schepman SM, Opheij W, Bruijnzeels MA. Understanding integrated care: a comprehensive conceptual framework based on the integrative functions of primary care. Int J Integr Care. 2013;13
7.
go back to reference Minkman MM. The current state of integrated care: an overview. J Integrated Care. 2012;20(6):346–58.CrossRef Minkman MM. The current state of integrated care: an overview. J Integrated Care. 2012;20(6):346–58.CrossRef
8.
go back to reference Coker TR, Windon A, Moreno C, Schuster MA, Chung PJ. Well-child care clinical practice redesign for young children: a systematic review of strategies and tools. Pediatrics. 2013;131(1):S5–S25.CrossRefPubMedPubMedCentral Coker TR, Windon A, Moreno C, Schuster MA, Chung PJ. Well-child care clinical practice redesign for young children: a systematic review of strategies and tools. Pediatrics. 2013;131(1):S5–S25.CrossRefPubMedPubMedCentral
9.
go back to reference Wolfe I, Thompson M, Gill P, Tamburlini G, Blair M, van den Bruel A, et al. Health services for children in western Europe. Lancet. 2013;381(9873):1224–34.CrossRefPubMed Wolfe I, Thompson M, Gill P, Tamburlini G, Blair M, van den Bruel A, et al. Health services for children in western Europe. Lancet. 2013;381(9873):1224–34.CrossRefPubMed
10.
go back to reference World Health Organization. Pairing children with health services. Copenhagen: WHO Regional Office for Europe; 2010. World Health Organization. Pairing children with health services. Copenhagen: WHO Regional Office for Europe; 2010.
11.
go back to reference Bezem J, Theunissen M, Buitendijk SE, Kocken PLA. Novel triage approach of child preventive health assessment: an observational study of routine registry-data. BMC Health Serv Res. 2014;14(1):498.CrossRefPubMedPubMedCentral Bezem J, Theunissen M, Buitendijk SE, Kocken PLA. Novel triage approach of child preventive health assessment: an observational study of routine registry-data. BMC Health Serv Res. 2014;14(1):498.CrossRefPubMedPubMedCentral
12.
go back to reference Baltag V, Levi M. Organizational models of school health services in the WHO European region. J Health Organ Manag. 2013;27(6):733–46.CrossRefPubMed Baltag V, Levi M. Organizational models of school health services in the WHO European region. J Health Organ Manag. 2013;27(6):733–46.CrossRefPubMed
13.
go back to reference Martínez-González NA, Djalali S, Tandjung R, Huber-Geismann F, Markun S, Wensing M, Rosemann T. Substitution of physicians by nurses in primary care: a systematic review and meta-analysis. BMC Health Serv Res. 2014;14(1):214.CrossRefPubMedPubMedCentral Martínez-González NA, Djalali S, Tandjung R, Huber-Geismann F, Markun S, Wensing M, Rosemann T. Substitution of physicians by nurses in primary care: a systematic review and meta-analysis. BMC Health Serv Res. 2014;14(1):214.CrossRefPubMedPubMedCentral
14.
go back to reference Buchan J, Dal Poz MR. Skill mix in the health care workforce: reviewing the evidence. Bulletin of WHO. 2002;80(7):575–80. Buchan J, Dal Poz MR. Skill mix in the health care workforce: reviewing the evidence. Bulletin of WHO. 2002;80(7):575–80.
15.
go back to reference Fulton BD, Scheffler RM, Sparkes SP, Auh EY, Vujicic M, Soucat A. Health workforce skill mix and task shifting in low income countries: a review of recent evidence. Hum Resour Health. 2011;9:1.CrossRefPubMedPubMedCentral Fulton BD, Scheffler RM, Sparkes SP, Auh EY, Vujicic M, Soucat A. Health workforce skill mix and task shifting in low income countries: a review of recent evidence. Hum Resour Health. 2011;9:1.CrossRefPubMedPubMedCentral
16.
go back to reference Bezem J, Theunissen M, Kamphuis M, Numans ME, Buitendijk SE, Kocken P. A novel triage approach to identifying health concerns. Pediatrics. 2016;137(3):e20150814 Bezem J, Theunissen M, Kamphuis M, Numans ME, Buitendijk SE, Kocken P. A novel triage approach to identifying health concerns. Pediatrics. 2016;137(3):e20150814
18.
go back to reference Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995:1–10. Andersen RM. Revisiting the behavioral model and access to medical care: does it matter? J Health Soc Behav. 1995:1–10.
19.
go back to reference Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12(1):18.CrossRefPubMedPubMedCentral Levesque JF, Harris MF, Russell G. Patient-centred access to health care: conceptualising access at the interface of health systems and populations. Int J Equity Health. 2013;12(1):18.CrossRefPubMedPubMedCentral
20.
go back to reference Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40.CrossRefPubMed Penchansky R, Thomas JW. The concept of access: definition and relationship to consumer satisfaction. Med Care. 1981;19(2):127–40.CrossRefPubMed
21.
go back to reference McColl E, Jacoby A, Thomas L, Soutter J, Bamford C, Steen N, et al. Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technol Assess. 2001;5(31) McColl E, Jacoby A, Thomas L, Soutter J, Bamford C, Steen N, et al. Design and use of questionnaires: a review of best practice applicable to surveys of health service staff and patients. Health Technol Assess. 2001;5(31)
22.
go back to reference Delnoij DM, Rademakers JJ, Groenewegen PP. The Dutch consumer quality index: an example of stakeholder involvement in indicator development. BMC Health Serv Res. 2010;10(1):88.CrossRefPubMedPubMedCentral Delnoij DM, Rademakers JJ, Groenewegen PP. The Dutch consumer quality index: an example of stakeholder involvement in indicator development. BMC Health Serv Res. 2010;10(1):88.CrossRefPubMedPubMedCentral
23.
go back to reference Koopman L, Sixma H, Hendriks M, de Boer D, Delnoij D, Manual CQI. Development. Guidelines and regulations for the development of a consumer quality index. In: Utrecht: Netherlands Institute for Health Services Research (NIVEL); 2011. Koopman L, Sixma H, Hendriks M, de Boer D, Delnoij D, Manual CQI. Development. Guidelines and regulations for the development of a consumer quality index. In: Utrecht: Netherlands Institute for Health Services Research (NIVEL); 2011.
24.
go back to reference Meulman JJ, Van der Kooij AJ, Heiser WJ. Principal components analysis with nonlinear optimal scaling transformations for ordinal and nominal data. The sage handbook of quantitative methodology for the social sciences. London: Sage Publications; 2004. p. 49–70. Meulman JJ, Van der Kooij AJ, Heiser WJ. Principal components analysis with nonlinear optimal scaling transformations for ordinal and nominal data. The sage handbook of quantitative methodology for the social sciences. London: Sage Publications; 2004. p. 49–70.
26.
go back to reference Hox JJ. Multilevel analysis: techniques and applications. 2nd ed. The Netherlands: Utrecht University; 2010. Hox JJ. Multilevel analysis: techniques and applications. 2nd ed. The Netherlands: Utrecht University; 2010.
27.
go back to reference Robinson S. Children and young people’s views of health professionals in England. J Child Health Care. 2010;38(1):94–9. Robinson S. Children and young people’s views of health professionals in England. J Child Health Care. 2010;38(1):94–9.
28.
go back to reference Brooten D, Youngblut JM. Nurse dose as a concept. J Nurs Sch. 2006;38(1):94–9.CrossRef Brooten D, Youngblut JM. Nurse dose as a concept. J Nurs Sch. 2006;38(1):94–9.CrossRef
Metadata
Title
Improving access to school health services as perceived by school professionals
Authors
Janine Bezem
Debbie Heinen
Ria Reis
Simone E. Buitendijk
Mattijs E. Numans
Paul L. Kocken
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2017
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-017-2711-4

Other articles of this Issue 1/2017

BMC Health Services Research 1/2017 Go to the issue