To explore the effects of state universal purchase (UP) of vaccines for all children, regardless of income or insurance status, on North Carolina physicians and families.
Pediatricians and family physicians (N=2163) were surveyed in 1995 to compare immunization charges in North Carolina (new UP) with those of Massachusetts (UP) and Texas (free market).
Main Outcome Measures Patient charges for immunizations and well-child visits and physician perceptions of the effects of state immunization programs.
Models were devised to simulate the net effect of the North Carolina UP program on immunization revenue for physicians and on families'out-of-pocket costs for well-child care.
Physician participation rates in the 2 UP programs were very high.
North Carolina physicians reported substantial decreases in immunization charges and reduced referrals to public clinics, but thought that UP increased their administrative burden.
Sixty percent of North Carolina physicians increased charges for well-child visits, nearly twice that in the 2 control states.
Families who previously had received immunizations from public clinics but chose to remain in the private-sector « medical home » for immunizations after implementation of UP had increased out-of-pocket expenses that varied by their insurance status. (...)
Mots-clés Pascal : Vaccin, Epidémiologie, Etude transversale, Communication information, Programme sanitaire, Enquête sur terrain, Immunisation, Facteur efficacité, Homme, Caroline du Nord, Etats Unis, Amérique du Nord, Amérique, Immunoprophylaxie
Mots-clés Pascal anglais : Vaccine, Epidemiology, Cross sectional study, Information communication, Sanitary program, Field inquiry, Immunization, Effectiveness factor, Human, North Carolina, United States, North America, America, Immunoprophylaxis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0020885
Code Inist : 002B05A02. Création : 17/04/1998.