Details:

Alternative Title:
Vaccine
Publisher's site:
http://dx.doi.org/10.1016/j.vaccine.2016.12.007
Personal Author:
Hurley, Laura P. ; Lindley, Megan C. ; Allison, Mandy A. ; Crane, Lori A. ; Brtnikova, Michaela ; ... More +
Hurley, Laura P. ; Lindley, Megan C. ; Allison, Mandy A. ; Crane, Lori A. ; Brtnikova, Michaela ; Beaty, Brenda L. ; Snow, Megan ; Bridges, Carolyn B. ; Kempe, Allison Less -
Description:
Background

Financial barriers to adult vaccination are poorly understood. Our objectives were to assess among general internists (GIM) and family physicians (FP) shortly after Affordable Care Act (ACA) implementation: 1) proportion of adult patients deferring or refusing vaccines because of cost and frequency of physicians not recommending vaccines for financial reasons; 2) satisfaction with reimbursement for vaccine purchase and administration by payer type; 3) knowledge of Medicare coverage of vaccines; and 4) awareness of vaccine-specific provisions of the ACA.

Methods

We administered an Internet and mail survey from June to October 2013 to national networks of 438 GIMs and 401 FPs.

Results

Response rates were 72% (317/438) for GIM and 59% (236/401) for FP. Among physicians who routinely recommended vaccines, up to 24% of GIM and 30% of FP reported adult patients defer or refuse certain vaccines for financial reasons most of the time. Physicians reported not recommending vaccines because they thought the patient’s insurance would not cover it (35%) or the patient could be vaccinated more affordably elsewhere (38%). Among physicians who saw patients with this insurance, dissatisfaction (‘very dissatisfied’) was highest for payments received from Medicaid (16 % vaccine purchase, 14 % vaccine administration) and Medicare Part B (11 % vaccine purchase, 11 % vaccine administration). Depending on the vaccine, 36–71% reported not knowing how Medicare covered the vaccine. Thirty-seven percent were ‘not at all aware’ and 19% were ‘a little aware’ of vaccine-specific provisions of the ACA.

Conclusions

Patients are refusing and physicians are not recommending adult vaccinations for financial reasons. Increased knowledge of private and public insurance coverage for adult vaccinations might position physicians to be more likely to recommend vaccines and better enable them to refer patients to other vaccine providers when a particular vaccine or vaccines are not offered in the practice.


Subject:
[+]
Adult
Article
Female
Humans
Immunization
Male
Middle Aged
Patient Protection And Affordable Care Act
Physicians, Primary Care
Surveys And Questionnaires
Vaccines

Source:
Vaccine. 35(4):647-654.
Pubmed ID:
28024954
Pubmed Central ID:
PMC5608447
Document Type:
Journal Article
Funding:
CC999999/Intramural CDC HHS/United States ; U48 DP001938/DP/NCCDPHP CDC HHS/United States
CC999999/Intramural CDC HHS/United States ; U48 DP001938/DP/NCCDPHP CDC HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:a0190ac015f8b7081694cb8905c281d1884607aa97859901056fe66e9ab914f2
File Type:

Supporting Files

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