School-Located Vaccination of Adolescents With Insurance Billing: Cost,Reimbursement, and Vaccination Outcomes |
| |
| Institution: | 1. Department of Pediatrics, University of Colorado Denver, Aurora, Colorado;2. Institute for Health Research, Kaiser Permanente Colorado, Denver, Colorado;3. Children''s Outcomes Research Program, Children''s Hospital Colorado, Aurora, Colorado;4. Colorado Health Outcomes Program, University of Colorado Denver, Aurora, Colorado;5. National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia;6. Department of Family Medicine, University of Colorado Denver, Aurora, Colorado;7. Health Systems, Management, and Policy, Colorado School of Public Health, Aurora, Colorado;8. Health Services Research, Denver Health, Denver, Colorado;9. Denver Public Health, Denver, Colorado;1. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland;2. Center for American Indian Health, Johns Hopkins School of Public Health, Baltimore, Maryland;1. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia;2. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia;1. Department of Obstetrics and Gynecology, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts;2. Department of Medicine, Division of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts;3. Department of Medicine, Division of Geriatrics, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts;4. Boston University School of Public Health, Edith Nourse Rogers Veterans Hospital, Boston, Massachusetts;5. Veterans Affairs Boston Healthcare System, Boston University School of Medicine, Boston, Massachusetts |
| |
| Abstract: | PurposeTo assess, in a school-located adolescent vaccination program that billed health insurance, the program costs, the proportion of costs reimbursed, and the likelihood of vaccination.MethodsDuring the 2010–2011 school year, vaccination clinics were held for sixth- to eighth-grade students at seven Denver public schools. Vaccine administration and purchase costs were compared with reimbursement by insurers. Multivariate analyses were used to compare the likelihood of vaccination among students in intervention schools with students in control schools who did not participate in the program, with analyses stratified by grade (sixth grade vs. seventh–eighth grades).ResultsFifteen percent (466 of 3,144) of students attending intervention schools were vaccinated at school-located vaccination clinics. Among students vaccinated at school, 41% were uninsured, 37% publicly insured, and 22% privately insured. Estimated vaccine administration costs were $23.98 per vaccine dose. Seventy-eight percent of vaccine purchase costs and 14% of vaccine administration costs were reimbursed by insurers; 41% of total program costs were reimbursed. Sixth-grade students in intervention schools were more likely than those in control schools to receive tetanus–diphtheria–acellular pertussis (risk ratio RR], 1.30; 95% confidence interval CI], 1.08, 1.57), meningococcal conjugate (RR, 1.42; CI, 1.18, 1.70), and human papillomavirus (for females only, RR, 1.69; CI, 1.21, 2.36) vaccines during the 2010–2011 school year, with similar results for seventh- to eighth-grade students.ConclusionsAlthough school-located adolescent vaccination with billing appears feasible and likely to improve vaccination rates, improvements in insurance coverage and reimbursement rates may be needed for the long-term financial sustainability of such programs. |
| |
| Keywords: | Immunization Vaccine School Adolescent Cost Billing Reimbursement |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
