Impact of vaccine economic programs on physician referral of children to public vaccine clinics: a pre-post comparisonReport as inadecuate

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BMC Public Health

, 6:7

First Online: 12 January 2006Received: 29 August 2005Accepted: 12 January 2006DOI: 10.1186-1471-2458-6-7

Cite this article as: Zimmerman, R.K., Tabbarah, M., Janosky, J.E. et al. BMC Public Health 2006 6: 7. doi:10.1186-1471-2458-6-7


BackgroundThe 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.

MethodsMinnesota 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.

ResultsThe 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.

ConclusionReported 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.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2458-6-7 contains supplementary material, which is available to authorized users.

Richard K Zimmerman, Melissa Tabbarah contributed equally to this work.

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Author: Richard K Zimmerman - Melissa Tabbarah - Janine E Janosky - Barbara Bardenheier - Judith A Troy - Ilene K Jewell - Barba


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