Details:

Alternative Title:
Ann Intern Med
Publisher's site:
http://dx.doi.org/10.7326/M13-2332
Personal Author:
Hurley, Laura P. ; Bridges, Carolyn B. ; Harpaz, Rafael ; Allison, Mandy A. ; O’Leary, Sean T. ; ... More +
Hurley, Laura P. ; Bridges, Carolyn B. ; Harpaz, Rafael ; Allison, Mandy A. ; O’Leary, Sean T. ; Crane, Lori A. ; Brtnikova, Michaela ; Stokley, Shannon ; Beaty, Brenda L. ; Jimenez-Zambrano, Andrea ; Ahmed, Faruque ; Hales, Craig ; Kempe, Allison ; Less -
Description:
Background Adults are at substantial risk for vaccine-preventable disease, but their vaccination rates remain low. Objective To assess practices for assessing vaccination status and stocking recommended vaccines, barriers to vaccination, characteristics associated with reporting financial barriers to delivering vaccines, and practices regarding vaccination by alternate vaccinators. Design Mail and Internet-based survey. Setting Survey conducted from March to June 2012. Participants General internists and family physicians throughout the United States. Measurements A financial barriers scale was created. Multivariable linear modeling for each specialty was performed to assess associations between a financial barrier score and physician and practice characteristics. Results Response rates were 79% (352 of 443) for general internists and 62% (255 of 409) for family physicians. Twenty-nine percent of general internists and 32% of family physicians reported assessing vaccination status at every visit. A minority used immunization information systems (8% and 36%, respectively). Almost all respondents reported assessing need for and stocking seasonal influenza; pneumococcal; tetanus and diphtheria; and tetanus, diphtheria, and acellular pertussis vaccines. However, fewer assessed and stocked other recommended vaccines. The most commonly reported barriers were financial. Characteristics significantly associated with reporting greater financial barriers included private practice setting, fewer than 5 providers in the practice, and, for general internists only, having more patients with Medicare Part D. The most commonly reported reasons for referring patients elsewhere included lack of insurance coverage for the vaccine (55% for general internists and 62% for family physicians) or inadequate reimbursement (36% and 41%, respectively). Patients were most often referred to pharmacies/retail stores and public health departments. Limitations Surveyed physicians may not be representative of all physicians. Conclusion Improving adult vaccination delivery will require increased use of evidence-based methods for vaccination delivery and concerted efforts to resolve financial barriers, especially for smaller practices and for general internists who see more patients with Medicare Part D. Primary Funding Source Centers for Disease Control and Prevention.
Subject:
[+]
Adult
Attitude Of Health Personnel
Female
Humans
Insurance, Health, Reimbursement
Interdisciplinary Communication
Internal Medicine
Male
Medically Uninsured
Middle Aged
Physician's Practice Patterns
Physicians, Family
Questionnaires
Referral And Consultation
Vaccination
Vaccines

Source:
Ann Intern Med. 160(3):161. ;
Pubmed ID:
24658693
Pubmed Central ID:
PMC4594851
Document Type:
Journal Article ;
Funding:
1001721223/Intramural CDC HHS/United States ; 5U48DP001938/DP/NCCDPHP CDC HHS/United States ;
1001721223/Intramural CDC HHS/United States ; 5U48DP001938/DP/NCCDPHP CDC HHS/United States ; Less -
Place as Subject:
United States ;
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:4ef4f8db4aebab60cd4e056ac6112d4d7c3e05b93772d4434986f050b2b40ffc
File Type:

Supporting Files

• 	NIHMS725883-supplement-supplemental.pdf	pdf
  	nihms725883.nxml	txt
  	nihms725883f1.gif	gif
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