Role of school-based health centers in referral completion

J Adolesc Health. 1997 Nov;21(5):328-34. doi: 10.1016/S1054-139X(97)00045-1.


Purpose: This study examined referrals from School-based health centers (SBHCs) to a sponsoring hospital to determine factors influencing successful referral completion and to assess SBHCs' ability to coordinate care.

Methods: A total of 138 referrals from eight SBHCs to Boston City Hospital between September 1993 and October 1994 were reviewed via medical records, clinic logs, and hospital registration system. A data extraction tool was used to collect information. Statistical analyses were performed to identify associations between referral completion and study variables.

Results: Seventy-five percent of all referrals were completed: 55.4% on the first attempt. Forty-six percent of those referred a second time completed their referrals. Statistically significant associations between referral completion and reason for referral (p = 0.01), visit diagnosis (p = 0.005), and usual source of health care (p = 0.009) were found. Provider documentation, including referral log and patient chart, was also associated with referral completion. Neither gender, race, nor health insurance had any significant association with successful referrals.

Conclusions: This study suggests that SBHCs can significantly contribute to coordinated care for adolescents, especially for the uninsured and those without a source of health care. SBHCs were particularly effective at facilitating referral to specific services including: family planning, tuberculosis prophylaxis, and subspecialty care. Provider action, such as making appointments and documentation, was also an important factor.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Health Services
  • Chi-Square Distribution
  • Continuity of Patient Care*
  • Female
  • Humans
  • Male
  • Patient Compliance
  • Referral and Consultation / organization & administration*
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • School Health Services / organization & administration*