Teachers who used school-based health care clinics as the source of primary care were significantly more likely to have fewer inpatient admissions and lower annual health care cost, and were less likely to be absent from work.

The Impact of Worksite Clinics on Teacher Healthcare Utilization and Cost, Self-Reported Health Status, and Student Academic Achievement Growth in a Public School District

Published in: Journal of Occupational and Environmental Medicine [Epub May 2018]. doi: 10.1097/JOM.0000000000001373

Posted on RAND.org on July 03, 2018

by John Engberg, Jon Harris-Shapiro, David Hines, Patti McCarver, Harry H. Liu

Research Question

  1. How would access to school-based health care clinics affect health care utilization and cost, teacher health, absenteeism, and job performance in a public school district?

Objective

To examine the impact of worksite clinics on health care utilization and cost, self-reported health status, and student achievement growth in a public school district.

Methods

We used insurance claims, health risk assessment, and student achievement growth data for active teachers during 2007-2015. A difference-in-differences approach was applied to measure the impact of worksite clinics.

Results

Compared to using a community-based clinic as the usual source of primary care, using a worksite clinic was associated with significantly lower inpatient admissions (53 vs. 31 per 1,000 teacher years), annual health care cost ($5,043 vs. $4,298 in 2016 US dollars, a difference of $62 per teacher per month), and annual absent work hours (63 vs. 61). No significant differences were detected in self-reported health status or student achievement growth.

Conclusions

Worksite clinics reduce teacher health care cost and absenteeism.

Key Findings

  • Teacher use of school-based primary care was significantly associated with reductions in health care utilization, cost, and absenteeism.
  • School-based clinic use was not associated with improvements in teacher self-reported health status or job performance as measured by student academic achievement growth.
  • Having clinics at the same location or near schools may help facilitate relationship building between employees and providers.
  • The finding of lowered primary care visits was unexpected, and may signal a difference in quality in comparison to care available at community-based clinics.
  • Additional research is warranted regarding improvements in health status.
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