Disproportionately high use of school health room (HR) services by sma
ll groups of users has been reported. This study investigated predicto
rs of frequent HR use in two suburban middle schools involving 1089 st
udents who made at least one HR visit during a single academic year. S
ubsets of high and low users were compared using logistic regression.
Predictor variables included gender, grade, academic ability, and exis
tence of a chronic health condition. Although demographic characterist
ics of the study schools varied significantly, a pattern of increasing
HR use associated with progressive lowering of academic ability was d
emonstrated in both schools. Existence of a chronic health condition w
as associated with increased HR use, even when controlling for routine
medication visits. Gender and grade were not predictive. These findin
gs suggest that HR use reflects more than medical concerns. Patterns o
f HR use by students with chronic health conditions deserve additional
study to determine whether current strategies to meet their needs are
adequate.