O2036: Campus Healthcare Crisis: An Analysis of Lack of Access and Availability Among College Populations

Background: College is a challenging transitional stage as youth must independently manage their health. Most colleges require proof of health insurance before matriculation and offer affiliated insurances. Therefore, with many students shifting physicians secondary to aging out, insurance change, and geographical positions, they must now rely on campus health facilities (CHF). This study examines the availability and accessibility of CHFs to determine whether they provide the care needed by these young adults.

Methods: The top 3 most enrolled colleges in each of the 50 US states were identified by CollegeFactual and College Raptor. The following data were collected from each college and CHF website: 1) student population (SP); 2) number of clinical staff (CS) (MD/DO, NP, and PA); 3) CHF hours, # days open/week, weekend availability; 4) reviews on appointment availability (on Google or Reddit); 5) insurance information; and 6) services available. Analysis was done in R at an α = .05.

Results: A total of 118 colleges were included, with a SP total (n=2,098,637). 82% (n=97) of colleges were public, while 18% (n=21) were private. 76% (n=90) of all colleges provided the cost of campus insurance, and 77% have their own insurance plan. The average cost of campus insurance was $3044.25. Welch’s t-test revealed that the average cost of campus insurance for public colleges did not significantly differ from private colleges (p=0.71). Figure 1 depicts the various health services that colleges provided through their CHFs.

Average CS:student ratio = 1:1,736 (Figure 2). Spearman’s coefficient test determined that the total undergraduate population is significantly correlated with student to staff ratio (ρ=0.398, p-value < 0.001); indicating less accessibility for students at larger universities. Out of 109 colleges, 80.5% of CHF had MD/DO. For 118 colleges, the average CHF opening time=8:00AM; closing time=4:30PM. Overall, 83.1% of CHF did not open on weekends. 71.2% (n=118) had reviews either on Google/Reddit about lack of availability and difficulty booking appointments at CHF.

Conclusion: Our results indicate there is a concerningly low CS:SP, which only worsens when SP is larger. The average hours of operation conflicts with most student class and activities schedules. The vast majority of colleges do not open on weekends, which is typically when students are most available to attend to their health needs. A large proportion of negative reviews addressed the lack of appointments/difficulty in accessing CHF and other medical facilities may be excluded from college health care plans. It is imperative for medical providers to address the lack of on campus healthcare needs and provide resources for college students in need of medical attention.