School nurses' role in asthma management, school absenteeism, and cost savings: a demonstration project

J Sch Health. 2013 Dec;83(12):842-50. doi: 10.1111/josh.12102.

Abstract

Background: With increasing budget cuts to education and social services, rigorous evaluation needs to document school nurses' impact on student health, academic outcomes, and district funding.

Methods: Utilizing a quasi-experimental design, we evaluated outcomes in 4 schools with added full-time nurses and 5 matched schools with part-time nurses in the San Jose Unified School District. Student data and logistic regression models were used to examine predictors of illness-related absenteeism for 2006-2007 and 2008-2009. We calculated average daily attendance (ADA) funding and parent wages associated with an improvement in illness-related absenteeism. Utilizing parent surveys, we also estimated the cost of services for asthma-related visits to the emergency room (ER; N = 2489).

Results: Children with asthma were more likely to be absent due to illness; however, mean absenteeism due to illness decreased when full-time nurses were added to demonstration schools but increased in comparison schools during 2008-2009, resulting in a potential savings of $48,518.62 in ADA funding (N = 6081). Parents in demonstration schools reported fewer ER visits, and the estimated savings in ER services and parent wages were significant.

Conclusion: Full-time school nurses play an important role in improving asthma management among students in underserved schools, which can impact school absenteeism and attendance-related economic costs.

Keywords: asthma; chronic disease; cost savings; school absenteeism; school nurse.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absenteeism*
  • Adolescent
  • Asthma / therapy*
  • California
  • Child
  • Costs and Cost Analysis
  • Disease Management
  • Emergency Service, Hospital / economics*
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Humans
  • Male
  • School Health Services / organization & administration*
  • School Nursing / organization & administration*
  • Socioeconomic Factors