Economic Evaluation of School-based Health Centers: A Community Guide Systematic Review
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Economic Evaluation of School-based Health Centers: A Community Guide Systematic Review

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  • Alternative Title:
    Am J Prev Med
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    Context: A recent Community Guide systematic review of the effectiveness of school-based health centers (SBHCs) showed that SBHCs improved educational and health outcomes. The objective of the present review is to evaluate the economic cost and benefit of SBHCs. Evidence acquisition: Using economic systematic review methods developed for the Guide to Community Preventive Services, 6,958 papers were identified for the search period January 1985 to September 2014. After two rounds of screening, 22 studies were included in this review. Among them, 15 studies reported on cost and 10 on benefit. Evidence synthesis: Analyses were conducted in 2014. Intervention cost had two main components: start-up cost and operation cost. All but two of the cost studies reported operation cost only, which ranged from $16,300 to $659,684 yearly per SBHC. Benefits included healthcare cost averted, productivity and other loss averted. From the societal perspective, total annual benefit per SBHC ranged from $15,028 to $912,878. From the healthcare payers’ perspective, particularly Medicaid, SBHCs led to net savings ranging from $30 to $969 per visit, and $46 to $ 1,166 per person. Additionally, two benefit studies used regression analysis to show that Medicaid cost and hospitalization cost decreased with the presence of SBHCs. Finally, results from two cost-benefit studies showed that the societal benefit per SBHC exceeded intervention cost, with the benefit-cost ratio ranging from 1.38 to 3.05. Conclusions: The economic benefit of SBHCs exceeded the intervention operation cost. Further, SBHCs were related to net savings to Medicaid.
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