Rosenthal J, Brink E, Rodewald L; Association for Health Services Research. Meeting.
Abstr Book Assoc Health Serv Res Meet. 1999; 16: 69.
Health Service Research and Evaluation Branch, National Immunization Program, CDC, 12 Corporate Square Blvd, Rm 4203, MS-E52, Atlanta, GA 30329, USA.
BACKGROUND: Private providers' attitudes and practices regarding current immunization policies and their likelihood of support and compliance with future policies are critical to ensure immunization services of high quality and appropriateness and are determinants of immunization rates among preschool children. A majority of US physicians refer some of their patients to other providers for immunizations because of financial reasons. Acceptance and implementation of current and new vaccine policies may be inappropriately delayed by providers. OBJECTIVE: To compare national immunization attitudes and practices of private pediatricians (PED) and family physicians (FP) in 1995 and 1997-8. DESIGN/METHODS: Two independent national random samples of private practice physicians (1995, N=793; and 1997-8, N=1523) who administered immunizations to preschool children and adolescents. 1997 questionnaires included some items used in 1995 and new items. Self-administered questionnaires were used and $50 participation incentive was provided. 1995 and 1997-8 completed questionnaires were received from 80% and 78% of physicians surveyed, respectively. RESULTS: Most pediatricians and family physicians significantly increased the delivery of timely vaccinations between 1995 and 1997-8(p<0.01): Hepatitis B [FPs 78% vs. 86%]; DTP/Hib [PEDs 80% vs. 87% and FPs 62% vs. 76%]. In 1995, 85% of PEDs vs. 77% of FPs reported they would administer varicella vaccine if available, and in 1997-8, 62% of PEDs and 29% of FPs reported actually administering varicella vaccine. Referral to private sector decreased significantly: PEDs 69% down to 48% and FPs 77% down to 42%. No changes were noted in use of reminder/recall systems between 1995 and 1997-8: PEDs 44% vs 46%, FPs 33% vs. 35%. Participation in the Vaccines for Children Program (VFC) increased between study periods: PEDs 36% to 70%, FPs 42% to 51%. VFC providers were less likely to refer patients for immunization than non-VFC participant providers between 1995 and 1997-8: PEDs 25% vs 47%, FPs: 88% vs 35%. CONCLUSION: Overall, the delivery of timely immunizations had improved between 1995 and 1997-8. However, FPs had slightly lower improvements compared to PEDs. Both types of physicians anticipated greater use of varicella vaccine in 1995 than they actually realized in 1997-8. Although both types of physicians decreased referral of children to the public sector, providers providing VFC had a larger impact on reducing the odds of referral. Implementing reminder/recall systems to improve the timeliness of vaccination is an important evidence-based strategy that continues to be underutilized by immunization providers.
Publication Types:
Keywords:
- Adolescent
- Chickenpox Vaccine
- Child
- Data Collection
- Diphtheria-Tetanus-Pertussis Vaccine
- Humans
- Immunization
- Immunization Programs
- Physicians
- Physicians, Family
- Questionnaires
- Referral and Consultation
- Vaccination
- Vaccines
- methods
- hsrmtgs
Other ID:
UI: 102194426
From Meeting Abstracts