National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Public Health Manag Pract. 2013 May-Jun;19(3):220-3. doi: 10.1097/PHH.0b013e31825874c3.
CONTEXT: In June 2009, the World Health Organization officially declared an influenza pandemic. In the United States, the federal government supplied 2009 H1N1 vaccine at no cost and provided funding for states to implement vaccination programs. Vaccine providers including health departments were permitted to bill insurance plans for administering 2009 H1N1 vaccine. OBJECTIVE: To determine the extent to which local health departments (LHDs) billed for administering 2009 H1N1 vaccine, specific billing practices of LHDs, and factors associated with LHD billing. DESIGN: Cross-sectional study using an Internet-based survey, and semistructured interviews. PARTICIPANTS AND SETTING: Nationally representative stratified random sample of 527 LHDs in the United States. Interviews were conducted among a convenience sample of LHDs. MAIN OUTCOME MEASURE: Proportion of LHDs reporting billing for administering 2009 H1N1 vaccine. RESULTS: A total of 308 health departments (58%) provided responses complete enough for analysis. Most LHDs (82%) had previous experience billing for seasonal influenza vaccination, but only 20% (n = 57) billed for administration of 2009 H1N1 vaccine. Medicare (74%) and Medicaid (80%) were the most commonly billed health care payers; more than half (55%) of LHDs billing for 2009 H1N1 vaccine administration sought reimbursement from one or more private insurance plans. Billing for 2009 H1N1 vaccine administration was more common among LHDs that previously offered seasonal influenza vaccination (P = .003), previously billed for seasonal influenza vaccination (P = .04), and conducted school-located influenza vaccination clinics prior to the 2009-2010 influenza season (P = .002). CONCLUSIONS: Most LHDs elected not to bill for 2009 H1N1 vaccine administration despite prior experience billing for influenza vaccination. It is important to understand barriers to billing and resources needed by LHDs to facilitate billing for vaccination. Developing public health billing capacity will allow LHDs to recoup the costs of providing vaccines to insured persons and may also prepare them to conduct billing activities for other services or during future public health emergencies.
背景：2009 年 6 月，世界卫生组织正式宣布发生流感大流行。在美国，联邦政府免费提供 2009 年 H1N1 疫苗，并为各州实施疫苗接种计划提供资金。疫苗接种提供者（包括卫生部门）被允许向保险公司收取接种 2009 年 H1N1 疫苗的费用。
目的：确定地方卫生部门（LHD）收取 2009 年 H1N1 疫苗接种费用的程度、LHD 特定的计费做法，以及与 LHD 计费相关的因素。
设计：使用基于互联网的调查和半结构化访谈的横断面研究。
参与者和设置：美国全国范围内具有代表性的分层随机抽样的 527 个 LHD。对 LHD 的便利样本进行了访谈。
主要观察指标：报告收取 2009 年 H1N1 疫苗接种费用的 LHD 的比例。
结果：共有 308 个卫生部门（58%）提供了足够完整的分析回复。大多数 LHD（82%）有过季节性流感疫苗接种计费的经验，但只有 20%（n=57）收取 2009 年 H1N1 疫苗接种费用。医疗保险（74%）和医疗补助（80%）是最常见的计费医疗支付者；超过一半（55%）收取 2009 年 H1N1 疫苗接种费用的 LHD 向一个或多个私人保险计划寻求报销。在 2009-2010 流感季节之前，曾提供季节性流感疫苗接种（P=.003）、之前有过季节性流感疫苗接种计费（P=.04）和进行学校定位流感疫苗接种的 LHD 更常见（P=.002）。
结论：尽管有接种流感疫苗计费的经验，但大多数 LHD 选择不收取 2009 年 H1N1 疫苗接种费用。了解计费障碍和 LHD 计费所需的资源非常重要，这有助于促进疫苗接种计费。发展公共卫生计费能力将使 LHD 能够收回为保险人员提供疫苗的成本，也可能使他们为其他服务或在未来的公共卫生紧急情况下进行计费活动做好准备。
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