Pediatrics Research Today is a free monthly online journal that collates and summarizes the latest research about Pediatrics, including details on child development, perinatal medicine, child health care.

Impact of vaccine economic programs on physician referral of children to public vaccine clinics: a pre-post comparison.

Zimmerman RK, Tabbarah M, Janosky JE, Bardenheier B, Troy JA, Jewell IK, Yawn BP

Department of Family Medicine and Clinical Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. zimmer@pitt.edu

BACKGROUND: The Vaccines for Children (VFC) Program is a major vaccine entitlement program with limited long-term evaluation. The objectives of this study are to evaluate the effect of VFC on physician reported referral of children to public health clinics and on doses administered in the public sector. METHODS: Minnesota and Pennsylvania primary care physicians (n = 164), completed surveys before (e.g., 1993) and after (2003) VFC, rating their likelihood on a scale of 0 (very unlikely) to 10 (very likely) of referring a child to the health department for immunization. RESULTS: The percentage of respondents likely to refer was 60% for an uninsured child, 14% for a child with Medicaid, and 3% for a child with insurance that pays for immunization. Half (55%) of the physicians who did not participate in VFC were likely to refer a Medicaid-insured child, as compared with 6% of those who participated (P < 0.001). Physician likelihood to refer an uninsured child for vaccination, measured on a scale of 0 to 10 where 10 is very likely, decreased by a mean difference of 1.9 (P < 0.001) from pre- to post-VFC. The likelihood to refer a Medicaid-insured child decreased by a mean of 1.2 (P = 0.001). CONCLUSION: Reported out-referral to public clinics decreased over time. In light of increasing immunizations rates, this suggests that more vaccines were being administered in private provider offices.

Published 6 March 2006 in BMC Public Health, 6: 7.
Full-text of this article is available online (may require subscription).

© 2005-2008 Pediatrics Research Today. All Rights Reserved.