A nationwide survey of school health services delivery in urban schools.

To understand school health service delivery models, and to plan for reorganization of a local school health service, a telephone survey of school-based health programs from around the country was conducted in 1992. Responses were elicited from 33 school departments in some of the largest American cities. Respondents described their current programs, obstacles they face, and approaches they have chosen to address the needs of urban schoolchildren. City size did affect amount of services provided overall, but a clear relationship existed between number of providers employed, and the number/amount of screening services available. Cities employed a range of strategies to enhance services, including collaboration with local health authorities, creation of school clinics, and billing for services.