Volume matters: physician practice characteristics and immunization coverage among young children insured through a universal health plan

Pediatrics
Astrid GuttmannTherese A Stukel

Abstract

We studied the association between immunization coverage for a cohort of 2-year-old children covered by a universal health insurance plan and pediatric provider and other health services characteristics. We assembled a cohort of 101,570 infants born in urban areas in Ontario, Canada, between July 1, 1997, and June 31, 1998. Children were considered to have up-to-date (UTD) immunization coverage if they had > or =5 immunizations by 2 years of age, ie, the recommended 3 doses and 1 booster of diphtheria-polio-tetanus-pertussis/Haemophilus influenzae type b vaccine and 1 dose of measles-mumps-rubella vaccine. Provider practice characteristics were derived from outpatient billing records, and 1996 census data were used to derive neighborhood income quintiles. The association between UTD immunization status and provider characteristics was assessed with multilevel regression models, controlling for patient characteristics. Overall, the rate of complete UTD immunization coverage was low (66.3%) despite a large number of primary care visits (median: 19 visits). Children whose usual provider had a low volume of pediatric primary care were less than one half as likely to be UTD. Other factors associated with not being UTD included very ...Continue Reading

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Citations

May 3, 2011·Healthcare Policy = Politiques De Santé·Catherine L MahRaisa B Deber
May 29, 2010·Journal of Biomedicine & Biotechnology·Steve G RobisonSusan A Arbor
Feb 11, 2012·Academic Pediatrics·Kevin J DombkowskiSarah J Clark
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Mar 23, 2017·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Marc R Rohrbach, Aaron M Wieland

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