Colleges can support students with chronic medical conditions

1. Private and public US 4-year colleges are capable of managing the increased primary care needs of youth with chronic medical conditions (YCMC) such as asthma, type 1 diabetes, and depression.

2. Few colleges have systems in place to identify and register YCMC, limiting the utilization of these services among the youth who need them.

Evidence Rating Level: 2 (Good)

Study Rundown: As the number of youth living with chronic medical conditions increases, the demand on college health services to provide appropriate care for this population as they go to college rises as well. In this study, medical directors at 200 representative US colleges were asked to complete surveys describing their systems for identification and resources for the care and support of students with 3 common chronic health conditions: asthma, type 1 diabetes and depression. A third of schools surveyed had registries of incoming YCMC based on reviews of their medical history, while a quarter of health centers actively contacted YCMC to make appointments. The vast majority of colleges had the resources to manage asthma and type 1 diabetes in their on-campus clinics, while about half could manage depression. An even larger proportion of institutions could provide on-campus primary care for these youth. The transition from pediatrics to adult care often happens when youth attend college, putting the onus on college health services to act as a bridge. As such, it is important to explore and strengthen opportunities to facilitate this shift in care for a population that needs it most. Although this study begins the process of this exploration, it excludes community and technical colleges from its sample, limiting the generalization of findings to 4-year institutions.

Click to read the study published in Pediatrics

Relevant Reading: Young adult patients with a history of pediatric disease: impact on course of life and transition into adulthood

In-Depth [cross-sectional study]: This study identified a representative sample of 200 4-year US colleges from the Department of Education’s Integrated Postsecondary Education Data System. Of the institutions, 153 (76.5%) completed a survey of their health services. Of the responders, 42% had no system of identifying incoming YCMC. Thirty-one percent of schools had a registry on review of their students’ incoming health records while 24% of schools contacted incoming YCMC to schedule initial appointments. Private and small (< 5000 students) schools were more likely to engage in these behaviors (P < .001 and P = .02 for private and P = .002 and P = .02 for small, respectively). Private, Eastern, small schools were more likely than medium or large public schools in other regions to identify and register YCMC with diabetes and asthma (P < .02). There were no significant regional differences regarding identification and registration for students with depression. The majority of schools could reportedly manage primary care needs of youths with asthma, diabetes and depression (83%, 69% and 72%, respectively). Eighty-three percent of schools could manage disease-related asthma problems on-campus while 69% could manage diabetes and 51% could manage depression. Large schools (enrollment > 10 000 students) were more likely to state that they could manage diabetes (P =.03) when compared to smaller schools. No significant regional differences or differences based upon public/private school status were observed regarding stated ability to care for these disease processes.

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