Schempf Ashley H, Politzer Robert M, Wulu John
Pennsylvania State University, USA.
Med Care Res Rev. 2003 Mar;60(1):85-100. doi: 10.1177/1077558702250246.
Serving a predominantly poor and minority population, health centers are positioned to address national immunization disparities in the context of comprehensive primary care. Having demonstrated success in eliminating disparities for other preventive services, this study evaluates health center effectiveness in mitigating immunization disparities. Up-to-date health center and national immunization rates were obtained from the 1995 User and the 1995 National Health Interview Surveys. For the most part, national immunization disparities were not found among health center children. However, black children served at health centers were still significantly less likely to be vaccinated for polio and Medicaid children significantly less likely for measles. Health center outreach and enabling services are hypothesized to facilitate regular access to care and thus timely immunization. Additional health center analysis is necessary to establish factors responsible for the relative absence of disparties, uncover persistent barriers to immunization, and identify structural attributes that may further raise immunization coverage.
健康中心主要服务于贫困和少数族裔人群,在综合初级保健背景下,有能力解决全国免疫接种差异问题。鉴于在消除其他预防服务差异方面已取得成功,本研究评估了健康中心在缓解免疫接种差异方面的成效。最新的健康中心和全国免疫接种率数据来自1995年用户调查和1995年全国健康访谈调查。在很大程度上,健康中心的儿童中未发现全国免疫接种差异。然而,在健康中心接受服务的黑人儿童接种小儿麻痹症疫苗的可能性仍然显著较低,而医疗补助儿童接种麻疹疫苗的可能性也显著较低。据推测,健康中心的外展服务和支持性服务有助于促进定期获得医疗服务,从而及时进行免疫接种。需要对健康中心进行更多分析,以确定造成差异相对较少的因素,找出免疫接种方面持续存在的障碍,并确定可能进一步提高免疫接种覆盖率的结构属性。