TOP 22 - Investigating the Association Between Healthcare Contact and Chronic School Absenteeism: Insights from Integrated Clinical and Educational Data

Publication Number: 2774.TOP 22

Allen Yiu, Children's National Health System, Washington, DC, United States; Janaylin Carela, Children's Hospital Medical Center, Silver Spring, MD, United States; Victoria Biancavilla, George Washington University School of Medicine and Health Sciences, Washington, DC, United States; Danielle Dooley, Children's National Health System, Washington, DC, United States

Background: Chronic school absenteeism, defined as missing 10% or more school days annually, is strongly linked to poor academic achievement and reduced economic opportunity. Poor health is both a cause and consequence of absenteeism: children with unmanaged health conditions are more likely to miss school, which disrupts skill acquisition and perpetuates a cycle of academic disengagement and further absences. As such, in 2023, the National Academy of Medicine selected chronic absenteeism as a core "vital sign" in pediatrics, underscoring the importance of school attendance in the health and development of children. While the cause for chronic absenteeism is multifactorial, with overlapping individual, family, social, and medical factors, few studies have examined how patterns of healthcare utilization, in particular preventive services such as well-child visits, relate to school attendance. Through a cross-sector data-sharing initiative, this study offers a novel insight on absenteeism by linking it to patterns of preventative healthcare engagement, highlighting potentially missed opportunities for early intervention.

Objective: To examine the association between healthcare system engagement, specifically preventive and acute care utilization, and chronic school absenteeism.

Design/Methods: This retrospective study reviewed 227 medical records of pediatric patients at our institution with school absences during 2024-2025 academic year. Attendance data were obtained through the Collaborative for Attendance Resources in Education and Health (CARE-H), a cross-collaboration partnership between our institution, our regional health information exchange, and the local school system. Clinical data abstracted from chart review included demographic information, number of emergency department (ED) visits, and well-child visits. Descriptive and inferential statistics will be conducting using R to assess relationships between healthcare utilization and chronic absenteeism. Preliminary findings show 144 students who were not chronically absent and 83 students who were chronically absent. Among non-chronically absent students, the mean number of total well-child visits was 9.86, and the mean number of ED visits in the past three years was 1.18. In contrast, chronically absent students had a lower mean number of well-child visits (6.41) and a higher number of mean ED visits in the past three years (5.10). Differences in well-child visits is visually represented in Figure 1. Institutional Review Board (IRB) exemption was granted by our institution for this study.

Distribution of Preventive Care Visits Among Chronically and Non-Chronically Absent Students
This figure illustrates the difference in the number of total well-child visits between students who were chronically absent (≥10% of school days missed) and those who were not. Students who were not chronically absent had a higher mean and median number of well-child visits compared to their chronically absent peers.