Norma J Allred1, Karen G Wooten, Yuan Kong. 1. National Center for Immunization and Respiratory Diseases, Division of Immunization Services, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. nallred@cdc.gov
Abstract
OBJECTIVE: Our goal was to examine the association of continuous care in the medical home and health insurance on up-to-date vaccination coverage by using data from the National Survey of Children's Health and the National Immunization Survey. METHODS: Interviews were conducted with 5400 parents of 19- to 35-month-old children to collect data on demographics and medically-verified vaccinations. Health insurance coverage was categorized as always, intermittently, or uninsured for the previous 12 months. Insurance types were private, public, or uninsured. Having a personal doctor or nurse and receiving preventive health care in either the past 12 or 24 months constituted continuous primary care in the medical home. Children were up-to-date if they received all vaccinations by 19 to 35 months of age (>or=4 doses of diphtheria and tetanus toxoids and pertussis vaccine, >or=3 doses of poliovirus vaccine, >or=1 dose of any measles-containing vaccine, >or=3 doses of Haemophilus influenzae type b vaccine, and >or=3 doses of hepatitis B vaccine). RESULTS: Bivariate analyses revealed children who were always insured had significantly higher vaccination coverage (83%) than those with lapses or uninsured during the past 12 months (75% and 71%, respectively). Those with continuous primary care in the medical home had significantly higher coverage than those who did not (83% vs 75%, respectively). In multivariate analysis, the same pattern of association was observed for insurance status and medical home, but the only statistically significant association was for children of never-married mothers who had significantly lower coverage (74%) compared with children of married mothers (84%). CONCLUSIONS: Among children with the same insurance status and continuity of care in the medical home, children of single mothers were less likely to be up-to-date than children of married mothers. Interventions assisting single mothers to obtain preventive care for their children should be a priority.
OBJECTIVE: Our goal was to examine the association of continuous care in the medical home and health insurance on up-to-date vaccination coverage by using data from the National Survey of Children's Health and the National Immunization Survey. METHODS: Interviews were conducted with 5400 parents of 19- to 35-month-old children to collect data on demographics and medically-verified vaccinations. Health insurance coverage was categorized as always, intermittently, or uninsured for the previous 12 months. Insurance types were private, public, or uninsured. Having a personal doctor or nurse and receiving preventive health care in either the past 12 or 24 months constituted continuous primary care in the medical home. Children were up-to-date if they received all vaccinations by 19 to 35 months of age (>or=4 doses of diphtheria and tetanus toxoids and pertussis vaccine, >or=3 doses of poliovirus vaccine, >or=1 dose of any measles-containing vaccine, >or=3 doses of Haemophilus influenzae type b vaccine, and >or=3 doses of hepatitis B vaccine). RESULTS: Bivariate analyses revealed children who were always insured had significantly higher vaccination coverage (83%) than those with lapses or uninsured during the past 12 months (75% and 71%, respectively). Those with continuous primary care in the medical home had significantly higher coverage than those who did not (83% vs 75%, respectively). In multivariate analysis, the same pattern of association was observed for insurance status and medical home, but the only statistically significant association was for children of never-married mothers who had significantly lower coverage (74%) compared with children of married mothers (84%). CONCLUSIONS: Among children with the same insurance status and continuity of care in the medical home, children of single mothers were less likely to be up-to-date than children of married mothers. Interventions assisting single mothers to obtain preventive care for their children should be a priority.
Authors: Jennifer E DeVoe; Carrie J Tillotson; Sarah E Lesko; Lorraine S Wallace; Heather Angier Journal: J Gen Intern Med Date: 2011-03-16 Impact factor: 5.128
Authors: Natalia V Oster; Emily C Williams; Joseph M Unger; Polly A Newcomb; Elizabeth N Jacobson; M Patricia deHart; Janet A Englund; Annika M Hofstetter Journal: Am J Prev Med Date: 2019-10 Impact factor: 5.043