Article Text

Original research
Associating school doctor interventions with the benefit of the health check: an observational study

Abstract

Background The benefits of school doctor interventions conducted at routine general health checks remain insufficiently studied. This study explored the associations of school doctor interventions with the doctor-evaluated and parent-evaluated benefits of routine health checks.

Methods Between August 2017 and August 2018, we recruited a random sample of 1341 children from grades 1 and 5 from 21 Finnish elementary schools in 4 municipalities. Doctors routinely examined all children, who were accompanied by parents. The doctor-reported interventions were categorised into six groups: instructions and/or significant discussions, prescriptions, laboratory tests and/or medical imaging, scheduling of follow-up appointments, referrals to other professionals and referrals to specialised care. Doctors evaluated the benefit of the appointment using predetermined criteria, and parents provided their subjective perceptions of benefit. Interventions and reported benefit were compared using multilevel logistic regression.

Results Doctors reported 52% and parents 87% of the appointments with interventions beneficial. All interventions were independently associated with doctor-evaluated benefit (ORs: 1.91–17.26). Receiving any intervention during the appointment was associated with parent-evaluated benefit (OR: 3.25, 95% CI 2.22 to 4.75). In analyses of different interventions, instructions and/or significant discussions (OR: 1.71, 95% CI 1.20 to 2.44), prescriptions (OR: 7.44, 95% CI 2.32 to 23.91) and laboratory tests and/or medical imaging (OR: 3.38, 95% CI 1.34 to 8.55) were associated with parent-evaluated benefit. Scheduled follow-up appointments and referrals to other professionals showed no significant association with parent-evaluated benefit.

Conclusions Doctors and parents valued the appointments with interventions. Parents especially appreciated immediate help and testing from the doctor.

Trial registration number NCT03178331.

  • health services research

Data availability statement

Data are available upon reasonable request. The datasets generated and analysed during the current study are not publicly available due to restrictions that applied under the license for the study but are available from the corresponding authors KN and MK on a reasonable request.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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