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The association between having a medical home and vaccination coverage among children eligible for the vaccines for children program.
Pediatrics. 2005 Jul; 116(1):130-9.Ped

Abstract

BACKGROUND

The Vaccines for Children (VFC) program is designed to reduce the cost of vaccines for vulnerable children, including Medicaid-eligible children, American Indian/Alaska Native children, uninsured children, and underinsured children whose health insurance does not cover the cost of vaccinations. A desired consequence of the program is to promote comprehensive continuous medical care within a medical home for these children.

OBJECTIVES

To explore how having a medical home is associated with vaccination coverage among children eligible for the program.

PARTICIPANTS

A total of 24514 children 19 to 35 months of age sampled by the National Immunization Survey.

DESIGN

VFC eligibility was evaluated for 24514 children 19 to 35 months of age who were sampled by the National Immunization Survey. Children were considered to have a medical home if they had a doctor, nurse, or physician's assistant who provided them with ongoing routine care, including well-child care, preventive care, and sick care, according to their parents. Sampled children were determined to be 4:3:1:3:3 up-to-date (UTD) if their vaccination providers reported administering >or=4 doses of diphtheria-tetanus toxoids-acellular pertussis vaccine, >or=3 doses of polio vaccine, >or=1 dose of measles-mumps-rubella vaccine, >or=3 doses of Haemophilus influenzae type b vaccine, and >or=3 doses of hepatitis B vaccine.

RESULTS

Nationally, 44.9% of all children were VFC eligible and 93.0% of the VFC-eligible children received all vaccine doses at a provider enrolled in the VFC program. Compared with children who were not VFC eligible, VFC-eligible children were less likely to be UTD (70.8% vs 77.7%) and less likely to have a medical home (82.1% vs 95.0%). However, among VFC-eligible children, children who had a medical home were significantly more likely to be UTD, compared with children who did not have a medical home (72.3% vs 63.5%). Also, among VFC-eligible children who had a medical home, children who used their medical home consistently to receive all of their vaccination doses were significantly more likely to be UTD, compared with children who did not receive all of their doses from their medical home (75.3% vs 65.7%). Finally, the 4:3:1:3:3 vaccination coverage rate among VFC-eligible children who received all of their vaccination doses from their medical home was not significantly different from that among non-VFC-eligible children, after controlling for significant differences in sociodemographic factors between these groups (adjusted difference: 2.8%; 95% confidence interval: -0.1% to 5.7%).

CONCLUSIONS

Although the vaccination coverage rate among VFC-eligible children who had a medical home and received all vaccine doses from their medical home was essentially equivalent to that of non-VFC-eligible children, substantial percentages of VFC-eligible children either did not have a medical home or did not use their medical home to receive all of their recommended vaccinations. The vaccination coverage rate among these children was significantly lower. This suggests that there may be opportunities to increase vaccination coverage by removing barriers that prevent the adoption and consistent use of a medical home among these children.

Authors+Show Affiliations

Centers for Disease Control and Prevention, National Immunization Program, MS E-32, 1600 Clifton Rd, NE, Atlanta, GA 30333, USA. psmith3@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15995043

Citation

Smith, Philip J., et al. "The Association Between Having a Medical Home and Vaccination Coverage Among Children Eligible for the Vaccines for Children Program." Pediatrics, vol. 116, no. 1, 2005, pp. 130-9.
Smith PJ, Santoli JM, Chu SY, et al. The association between having a medical home and vaccination coverage among children eligible for the vaccines for children program. Pediatrics. 2005;116(1):130-9.
Smith, P. J., Santoli, J. M., Chu, S. Y., Ochoa, D. Q., & Rodewald, L. E. (2005). The association between having a medical home and vaccination coverage among children eligible for the vaccines for children program. Pediatrics, 116(1), 130-9.
Smith PJ, et al. The Association Between Having a Medical Home and Vaccination Coverage Among Children Eligible for the Vaccines for Children Program. Pediatrics. 2005;116(1):130-9. PubMed PMID: 15995043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The association between having a medical home and vaccination coverage among children eligible for the vaccines for children program. AU - Smith,Philip J, AU - Santoli,Jeanne M, AU - Chu,Susan Y, AU - Ochoa,Dianne Q, AU - Rodewald,Lance E, PY - 2005/7/5/pubmed PY - 2005/12/15/medline PY - 2005/7/5/entrez SP - 130 EP - 9 JF - Pediatrics JO - Pediatrics VL - 116 IS - 1 N2 - BACKGROUND: The Vaccines for Children (VFC) program is designed to reduce the cost of vaccines for vulnerable children, including Medicaid-eligible children, American Indian/Alaska Native children, uninsured children, and underinsured children whose health insurance does not cover the cost of vaccinations. A desired consequence of the program is to promote comprehensive continuous medical care within a medical home for these children. OBJECTIVES: To explore how having a medical home is associated with vaccination coverage among children eligible for the program. PARTICIPANTS: A total of 24514 children 19 to 35 months of age sampled by the National Immunization Survey. DESIGN: VFC eligibility was evaluated for 24514 children 19 to 35 months of age who were sampled by the National Immunization Survey. Children were considered to have a medical home if they had a doctor, nurse, or physician's assistant who provided them with ongoing routine care, including well-child care, preventive care, and sick care, according to their parents. Sampled children were determined to be 4:3:1:3:3 up-to-date (UTD) if their vaccination providers reported administering >or=4 doses of diphtheria-tetanus toxoids-acellular pertussis vaccine, >or=3 doses of polio vaccine, >or=1 dose of measles-mumps-rubella vaccine, >or=3 doses of Haemophilus influenzae type b vaccine, and >or=3 doses of hepatitis B vaccine. RESULTS: Nationally, 44.9% of all children were VFC eligible and 93.0% of the VFC-eligible children received all vaccine doses at a provider enrolled in the VFC program. Compared with children who were not VFC eligible, VFC-eligible children were less likely to be UTD (70.8% vs 77.7%) and less likely to have a medical home (82.1% vs 95.0%). However, among VFC-eligible children, children who had a medical home were significantly more likely to be UTD, compared with children who did not have a medical home (72.3% vs 63.5%). Also, among VFC-eligible children who had a medical home, children who used their medical home consistently to receive all of their vaccination doses were significantly more likely to be UTD, compared with children who did not receive all of their doses from their medical home (75.3% vs 65.7%). Finally, the 4:3:1:3:3 vaccination coverage rate among VFC-eligible children who received all of their vaccination doses from their medical home was not significantly different from that among non-VFC-eligible children, after controlling for significant differences in sociodemographic factors between these groups (adjusted difference: 2.8%; 95% confidence interval: -0.1% to 5.7%). CONCLUSIONS: Although the vaccination coverage rate among VFC-eligible children who had a medical home and received all vaccine doses from their medical home was essentially equivalent to that of non-VFC-eligible children, substantial percentages of VFC-eligible children either did not have a medical home or did not use their medical home to receive all of their recommended vaccinations. The vaccination coverage rate among these children was significantly lower. This suggests that there may be opportunities to increase vaccination coverage by removing barriers that prevent the adoption and consistent use of a medical home among these children. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/15995043/The_association_between_having_a_medical_home_and_vaccination_coverage_among_children_eligible_for_the_vaccines_for_children_program_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=15995043 DB - PRIME DP - Unbound Medicine ER -