Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora.
Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora; Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora.
Acad Pediatr. 2017 Sep-Oct;17(7):770-777. doi: 10.1016/j.acap.2017.06.001. Epub 2017 Jun 7.
Vaccines represent a significant portion of primary care practice expenses. Our objectives were to determine among pediatric (Ped) and family medicine (FM) practices: 1) relative payment for vaccine purchase and administration and estimated profit margin according to payer type, 2) strategies used to reduce vaccine purchase costs and increase payment, and 3) whether practices have stopped providing vaccines because of finances.
A national survey conducted from April through September 2011 among Ped and FM practitioners in private, single-specialty practices.
The response rate was 51% (221 of 430). Depending on payer type, 61% to 79% of practices reported that payment for vaccine purchase was at least 100% of purchase price and 34% to 74% reported that payment for vaccine administration was at least $11. Reported strategies to reduce vaccine purchase cost were online purchasing (81% Ped, 36% FM), prompt pay (78% Ped, 49% FM), and bulk order (65% Ped, 49% FM) discounts. Fewer than half of practices used strategies to increase payment; in a multivariable analysis, practices with ≥5 providers were more likely to use strategies compared with practices with fewer providers (adjusted odds ratio, 2.65; 95% confidence interval, 1.51-4.62). When asked if they had stopped purchasing vaccines because of financial concerns, 12% of Ped practices and 23% of FM practices responded 'yes,' and 24% of Ped and 26% of FM practices responded 'no, but have seriously considered.'
Practices report variable payment for vaccination services from different payer types. Practices might benefit from increased use of strategies to reduce vaccine purchase costs and increase payment for vaccine delivery.
疫苗在初级保健实践费用中占很大比例。我们的目标是确定儿科 (Ped) 和家庭医学 (FM) 实践：1）根据付款人类型确定疫苗购买和管理的相对付款额和估计利润率，2）用于降低疫苗购买成本和增加付款的策略，以及 3）实践是否因财务问题停止提供疫苗。
2011 年 4 月至 9 月期间，对私人单一专业实践中的儿科和家庭医学从业者进行了一项全国性调查。
回应率为 51%（221/430）。根据付款人类型，61%至 79%的实践报告称疫苗购买的付款至少为购买价格的 100%，34%至 74%的实践报告称疫苗接种的付款至少为 11 美元。报告的降低疫苗购买成本的策略包括在线购买（81%的儿科，36%的家庭医学），及时付款（78%的儿科，49%的家庭医学）和批量订购（65%的儿科，49%的家庭医学）折扣。不到一半的实践使用增加付款的策略；在多变量分析中，与拥有较少提供者的实践相比，拥有≥5 名提供者的实践更有可能使用策略（调整后的优势比，2.65；95%置信区间，1.51-4.62）。当被问及是否因财务问题停止购买疫苗时，12%的儿科实践和 23%的家庭医学实践回答“是”，24%的儿科和 26%的家庭医学实践回答“否，但已认真考虑”。
实践报告不同付款人类型的疫苗接种服务支付情况存在差异。实践可能受益于增加使用降低疫苗购买成本和增加疫苗接种付款的策略。
