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Examining the Consulting Physician Model to Enhance the School Nurse Role for Children With Asthma


Kristin D. Wilson, Project Director, (, Department of Health Management and Policy, Saint Louis University School of Public Health, 3545 Lafayette Ave, Salus Center, Suite 300, Saint Louis, MO 63104.


BACKGROUND:  The Centers for Disease Control and Prevention’s Strategies for Addressing Asthma Within a Coordinated School Health Program recommends a consulting physician for schools to help manage asthma. The literature examines the effects when a school nurse is present, but the addition of a consulting physician is not well understood. The purpose of this study is to assess the effect of having a consulting physician on school absenteeism and children sent home due to health reasons for children with asthma and all children pooled together.

METHODS:  A 2-year preimplementation group cohort and 1-year implementation group cohort of grades K-6 in an urban school district were used to determine the impact of a consulting physician on school absenteeism for children with asthma and all children pooled together.

RESULTS:  A consulting physician was significantly associated with reduced missed school days for children with asthma and all children as a group. All children pooled together were 44% more likely (OR = 1.44, 95% CI = 1.31-1.58) to be sent home without the consulting physician. There was a reduction from 13.8% to 12.6% of sent home events in children with asthma.

CONCLUSIONS:  Having consulting physicians in school districts appears to be associated with fewer days of school absence. The results provide additional evidence and suggest that more research is required to determine if this association is valid and to better understand the cause of such an association.