Schulte J M, Bown G R, Zetzman M R, Schwartz B, Green H G, Haley C E, Anderson R J
Dallas County Hospital District, Parkland Memorial Hospital, Texas 75235.
Pediatrics. 1991 Feb;87(2):204-7.
Family practice physicians and pediatricians in Dallas County, Texas, were surveyed to determine how recent vaccine price increases have changed immunization referral patterns. A total of 73% of responding physicians referred some pediatric patients for immunization in 1988. Public health clinics were the largest referral source with more responding pediatricians (84.4%) referring patients than did responding family practitioners (66.5%). Referrals to the clinics were most often made when patients were unable to afford immunizations in a private practice setting. Between 1979 and 1988, the number of responding pediatricians and family practitioners making immunization referrals increased by 193% and 391%, respectively. The percentages of children referred for immunization increased by 693% during the same decade. It was suggested by our survey of Dallas County physicians that a new influx of patients are using public sector immunizations, potentially creating additional financial stress for public health programs. In addition, this shift to the public sector may undermine the health departments' ability to provide new vaccines or protect greater numbers of children with immunization.
对得克萨斯州达拉斯县的家庭医生和儿科医生进行了调查，以确定近期疫苗价格上涨如何改变了免疫接种转诊模式。1988年，共有73%的受访医生将一些儿科患者转诊进行免疫接种。公共卫生诊所是最大的转诊来源，转诊患者的受访儿科医生（84.4%）比受访家庭医生（66.5%）更多。当患者在私人诊所无法负担免疫接种费用时，最常将其转诊至这些诊所。1979年至1988年期间，进行免疫接种转诊的受访儿科医生和家庭医生数量分别增加了193%和391%。在同一十年中，被转诊进行免疫接种的儿童比例增加了693%。我们对达拉斯县医生的调查表明，新涌入的患者正在使用公共部门的免疫接种服务，这可能给公共卫生项目带来额外的财政压力。此外，这种向公共部门的转变可能会削弱卫生部门提供新疫苗或为更多儿童提供免疫保护的能力。
