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J Occup Environ Med. 2018 Aug;60(8):e397-e405. doi: 10.1097/JOM.0000000000001373.

The Impact of Worksite Clinics on Teacher Health Care Utilization and Cost, Self-Reported Health Status, and Student Academic Achievement Growth in a Public School District.

Author information

RAND Corporation (Dr Engberg), Pittsburgh, Pennsylvania; RAND Corporation, Boston, Massachusetts (Dr Liu); Continuance Health Solutions Inc. (Mr Harris-Shapiro); Metro Nashville Public Schools (Mr Hines); Vanderbilt University Medical Center (Dr McCarver).



The aim of this study was to examine the impact of worksite clinics on health care utilization and cost, self-reported health status, and student achievement growth in a public school district.


We used insurance claims, health risk assessment, and student achievement growth data for active teachers during 2007 to 2015. A difference-in-differences approach was applied to measure the impact of worksite clinics.


Compared with using a community-based clinic as the usual source of primary care, using a worksite clinic was associated with significantly lower inpatient admissions (53 vs 31 per 1000 teacher years), annual health care cost ($5043 vs $4298 in 2016 US dollars, a difference of $62 per teacher per month), and annual absent work hours (63 vs 61). No significant differences were detected in self-reported health status or student achievement growth.


Worksite clinics reduce teacher health care cost and absenteeism.

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