From Google Scholar & other sources: Selected Journal Articles, Newsletters, Dissertations, Theses, Commentary
Article in Press
Financing of Vaccine Delivery in Primary Care Practices
MA Allison, ST O’Leary, MC Lindley, LA Crane…
Vaccines represent a significant portion of primary care practices’ expenses. Our objectives were to determine among Pediatric (Ped) and Family Medicine (FM): 1) relative payment for vaccine purchase and administration and estimated profit margin by payer type, 2) strategies used to reduce vaccine purchase costs and increase payment, and 3) whether practices have stopped providing vaccines due to finances.
A national survey conducted April—September 2011 among Ped and FM in private, single-specialty practices.
The response rate was 51% (221/430). Depending on payer type, 61%–79% of practices reported that payment for vaccine purchase was at least 100% of purchase price and 34%–74% reported that payment for vaccine administration was at least $11. Reported strategies to reduce vaccine purchase cost were online purchasing (81% Ped, 36% FM), prompt pay (78% Ped, 49% FM) and bulk order (65% Ped, 49% FM) discounts. Fewer than half of practices used strategies to increase payment; in a multivariable analysis, practices with > 5 providers were more likely to use strategies compared to practices with fewer providers (adjusted odds ratio 2.65, 95% confidence interval 1.51-4.62). When asked if they had stopped purchasing vaccines due to financial concerns, 12% of Ped and 23% of FM responded ‘yes’, and 24% of Ped and 26% of FM responded ‘no, but have seriously considered’.
Practices report variable payment for vaccination services from different payer types. Practices may benefit from increased use of strategies to reduce vaccine purchase costs and increase payment for vaccine delivery.
Public Health Reports
First Published June 6, 2017
Longitudinal Trends in Vaccine Hesitancy in a Cohort of Mothers Surveyed in Washington State, 2013-2015
NB Henrikson, ML Anderson, DJ Opel, J Dunn… –
Parents who refuse or delay vaccines because of vaccine hesitancy place children at increased risk for vaccine-preventable disease. How parental vaccine hesitancy changes as their children age is not known. In 2015, we conducted a follow-up survey of 237 mothers enrolled in a 2-arm clinic-level cluster randomized trial (n = 488) in Washington State that was completed in 2013. We surveyed mothers at their baby’s birth, age 6 months, and age 24 months using a validated measure of vaccine hesitancy. Both mean hesitancy scores (mean 4.1-point reduction; 95% CI, 2.5-5.6; P = .01) and the proportion of mothers who were vaccine hesitant (9.7% at baseline vs 5.9% at 24 months; P = .01) decreased significantly from child’s birth to age 24 months. Changes from baseline were similar for first-time mothers and experienced mothers. Individual item analysis suggested that the decrease may have been driven by increases in maternal confidence about the safety and efficacy of vaccines. Our results suggest that hesitancy is a dynamic measure that may peak around childbirth and may remit as experience with vaccines accumulates.