A new method of evaluating selective school entrymedicals

There is an ongoing debate about the relative value of selective vs routine entrant medicals. This paper describes a districtwide study of entrant medicals using the tracer method to assess the prevalence and detection rates of problems at school entry. Overall 57% of school entrants were selected for a medical but there was a significant difference in selection rates in urban and rural schools. This selection rate is higher than that reported by other authors. There was a trend for tracer conditions to be more prevalent in urban areas although this was not statistically significant. Prevalence rates suggest that the method of selection successfully detected children with problems. The tracer methodology provided useful information for service planning without the collection of large amounts of data and has not, to our knowledge, been used before in community child health. We recommend this methodology to other districts as a simple and effective method of assessing selective entrant medicals.