Kempe Allison, Daley Matthew F, Pyrzanowski Jennifer, Vogt Tara, Fang Hai, Rinehart Deborah J, Morgan Nicole, Riis Mette, Rodgers Sarah, McCormick Emily, Hammer Anne, Campagna Elizabeth J, Kile Deidre, Dickinson Miriam, Hambidge Simon J, Shlay Judith C
Children's Outcomes Research Program, The Children's Hospital, Aurora, Colo; Department of Pediatrics, University of Colorado, Aurora, Colo; Colorado Health Outcomes Program, University of Colorado, Aurora, Colo.
Children's Outcomes Research Program, The Children's Hospital, Aurora, Colo; Department of Pediatrics, University of Colorado, Aurora, Colo; Institute for Health Research, Kaiser Permanente, Denver, Colo.
Acad Pediatr. 2014 May-Jun;14(3):234-40. doi: 10.1016/j.acap.2014.01.005.
To assess rates of immunization; costs of conducting clinics; and reimbursements for a school-located influenza vaccination (SLIV) program that billed third-party payers.
SLIV clinics were conducted in 19 elementary schools in the Denver Public School district (September 2010 to February 2011). School personnel obtained parental consent, and a community vaccinator conducted clinics and performed billing. Vaccines For Children vaccine was available for eligible students. Parents were not billed for any fees. Data were collected regarding implementation costs and vaccine cost was calculated using published private sector prices. Reimbursement amounts were compared to costs.
Overall, 30% of students (2784 of 9295) received ≥1 influenza vaccine; 39% (1079 of 2784) needed 2 doses and 80% received both. Excluding vaccine costs, implementation costs were $24.69 per vaccination. The percentage of vaccine costs reimbursed was 62% overall (82% from State Child Health Insurance Program (SCHIP), 50% from private insurance). The percentage of implementation costs reimbursed was 19% overall (23% from private, 27% from Medicaid, 29% from SCHIP and 0% among uninsured). Overall, 25% of total costs (implementation plus vaccine) were reimbursed.
A SLIV program resulted in vaccination of nearly one third of elementary students. Reimbursement rates were limited by 1) school restrictions on charging parents fees, 2) low payments for vaccine administration from public payers and 3) high rates of denials from private insurers. Some of these problems might be reduced by provisions in the Affordable Care Act.
评估免疫接种率；开展诊所的成本；以及向第三方付款人计费的学校流感疫苗接种（SLIV）计划的报销情况。
在丹佛公立学区的19所小学开展了SLIV诊所（2010年9月至2011年2月）。学校工作人员获得家长同意，由社区疫苗接种人员开展诊所并进行计费。符合条件的学生可获得儿童疫苗计划疫苗。家长无需支付任何费用。收集了有关实施成本的数据，并使用公布的私营部门价格计算疫苗成本。将报销金额与成本进行比较。
总体而言，30%的学生（9295名中的2784名）接种了≥1剂流感疫苗；39%（2784名中的1079名）需要接种2剂，80%的学生接种了2剂。不包括疫苗成本，每次接种的实施成本为24.69美元。疫苗成本的总体报销比例为62%（州儿童健康保险计划（SCHIP）报销82%，私人保险报销50%）。实施成本的总体报销比例为19%（私人报销23%，医疗补助报销27%，SCHIP报销29%，未参保者报销0%）。总体而言，总成本（实施成本加疫苗成本）的25%得到了报销。
SLIV计划使近三分之一的小学生接种了疫苗。报销率受到以下因素限制：1）学校对向家长收费的限制；2）公共付款人对疫苗接种管理的低支付；3）私人保险公司的高拒付率。《平价医疗法案》中的一些条款可能会减少其中一些问题。
