The future of school-based health centers depends on the ability to finance the centers, maximizing available reimbursement for primary care services. At present, the centers are facing an increasing number of clients enrolling in managed care plans, thus effectively cutting off their reimbursement for services. The current state of knowledge about the centers' operation and effectiveness is sparse and provides little incentive for managed care providers to reimburse for the increased access to care that the centers do provide. The purpose of this study is to describe and compare the cost-effectiveness of school-based health centers to a hospital-based intervention. The study will determine the structural, personal and financial factors affecting access to care in both sites. Effectiveness will be described using utilization and outcome measures. Cost and effectiveness data will be recorded and computerized over a period of one year.
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