Association between university students' two-staged health screening and student health care utilisation: register based observational study.
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ABSTRACT: Objectives
The aim of this study was to explore how university students' participation in a two-staged health screening at the beginning of university studies associates with student health care utilisation in a 6-year follow-up.Design
Nationwide, observational, register-based cohort study with a 6-year follow-up.Setting
Student health care in Finland. Finnish Student Health Service (FSHS) provides statutory student health services to university students in Finland. The two-staged health screening of FSHS includes the electronic health questionnaire (eHQ) provided annually to university entrants and a subsequent health check, when necessary, based on students eHQ response.Participants
A national cohort of university entrants from the 2011-2012 academic year (N=15 723) was assessed. After exclusions the study population consisted of 12 972 students, n (female)=7368, n (male)=5604.Outcome measures
The primary outcome measures were students' health service utilisation pattern obtained by clustering analyses method and the students' participation in different stages of the health examination process.Results
Four distinguishable health care utilisation patterns were identified: (1) constant low use, (2) constant high use, (3) increasing use and (4) decreasing use. The students' OR for belonging to the constant high use group was significantly higher among females (OR 4.0, 95% CI 3.5 to 4.6) and students who attended the health check (OR 4.7, 95% CI 3.9 to 5.6).Conclusions
Participating in the two-staged health screening was associated with increase in health care utilisation. The process detects students with health problems.
SUBMITTER: Seilo N
PROVIDER: S-EPMC9277381 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:Health questionnaires and health checks are an established part of preventive health care services in Finland. However, only very limited research of these has been conducted. The Finnish Student Health Service (FSHS) provides primary health care services to all bachelor's and master's degree university students (approximately 134,500 students) in Finland. FSHS's statutory health examination process of university entrants includes an electronic health questionnaire (eHQ) and, based on the students' eHQ responses, a subsequent health check if necessary. To our knowledge, no previous studies have been published on the use of questionnaires for screening students for general health checks. OBJECTIVE:The general aim of the study is to evaluate the health examination process of university entrants. The objectives are to determine how students' self-reported health in the eHQ and participation in the health examination process are associated with graduation, mental health problems, and the use of student health care services. METHODS:This is an ongoing, nationwide, retrospective, register-based cohort study with a 6-year follow-up. The study population is the cohort of university entrants (N=15,723) from the 2011-2012 academic year. These students were sent the eHQ, which consisted of 26 questions about health, health habits, social relations, and studying. Based on the eHQ responses, students were referred to one of the following interventions: (1) a health check, (2) an appointment other than a health check (eg, physiotherapy), or (3) electronic feedback to support a healthy lifestyle, when the other interventions were not necessary. Multiple comparisons will be made within these groups using logistic regression. The primary outcome variables are graduation, having a mental health problem, and attending a health check. The use of FSHS health care services will be studied with the cluster analysis method. The data have been obtained from three nationwide registers: the eHQ register, the medical records of FSHS, and the Higher education achievement register. The data have been linked using personal identity codes. RESULTS:As of August 2019, the data collection and processing are complete and the statistical analyses are in progress. Preliminary results are expected in autumn 2019. Further publications are expected in 2020, and two PhD theses are expected to be completed by the end of 2022. CONCLUSIONS:Studying practical procedures in primary health care is highly important for resource allocation and the development of evidence-based processes. This study will be the first to assess the usage of a health questionnaire in screening students for health checks. The findings of this study will contribute to the field of preventive health care. The main practical implication is the development of the FSHS's health examination process. We hypothesize that participation in the health examination process enhances academic achievement and the detection of university students' mental health problems early on in their studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID):DERR1-10.2196/14535.
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