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儿科医生在儿童疫苗计划中的经验和看法。

Pediatricians' Experiences With and Perceptions of the Vaccines for Children Program.

机构信息

Adult and Child Consortium for Health Outcomes Research and Delivery Science, School of Medicine, University of Colorado and Children's Hospital Colorado, Aurora, Colorado;

Department of Pediatrics and.

出版信息

Pediatrics. 2020 Mar;145(3). doi: 10.1542/peds.2019-1207. Epub 2020 Feb 21.

Abstract

BACKGROUND AND OBJECTIVES

The Vaccines for Children Program (VFC) provides vaccines for children who may not otherwise be vaccinated because of financial barriers. Pediatrician participation is crucial to the VFC's ongoing success. Our objectives were to assess, among a national sample of pediatricians, (1) VFC program participation, (2) perceived burden versus benefit of participation, and (3) knowledge and perception of a time-limited increased payment for VFC vaccine administration under the Patient Protection and Affordable Care Act.

METHODS

An electronic and mail survey was conducted from June 2017 to September 2017.

RESULTS

Response rate was 79% (372 of 471); 86% of pediatricians reported currently participating in the VFC; among those, 85% reported never having considered stopping, 10% considered it but not seriously, and 5% seriously considered it. Among those who had considered no longer participating ( = 47), the most commonly reported reasons included difficulty meeting VFC record-keeping requirements (74%), concern about action by the VFC for noncompliance (61%), and unpredictable VFC vaccine supplies (59%). Participating pediatricians rated, on a scale from -5 (high burden) to +5 (high benefit), their overall perception of the VFC: 63% reported +4 or +5, 23% reported +1 to +3, 5% reported 0, and 9% reported -1 to -5. Of pediatricians, 39% reported awareness of temporary increased payment for VFC vaccine administration. Among those, 10% reported that their practice increased the proportion of Medicaid and/or VFC-eligible patients served on the basis of this change.

CONCLUSIONS

For most pediatricians, perceived benefits of VFC participation far outweigh perceived burdens. To ensure the program's ongoing success, it will be important to monitor factors influencing provider participation.

摘要

背景与目的

儿童疫苗计划(VFC)为那些因经济障碍而无法接种疫苗的儿童提供疫苗。儿科医生的参与对 VFC 的持续成功至关重要。我们的目标是评估全国儿科医生样本中的以下内容:(1)VFC 计划参与情况;(2)参与的感知负担与收益;(3)对《患者保护与平价医疗法案》下 VFC 疫苗接种限时增加付款的了解和看法。

方法

我们于 2017 年 6 月至 9 月进行了一项电子和邮件调查。

结果

回应率为 79%(372/471);86%的儿科医生报告称目前参与了 VFC;其中,85%的医生表示从未考虑过停止参与,10%的医生表示考虑过但不认真,5%的医生认真考虑过。在那些考虑不再参与的医生中(=47),报告的最常见原因包括难以满足 VFC 记录保存要求(74%)、担心因不遵守规定而被 VFC 采取行动(61%)以及 VFC 疫苗供应不可预测(59%)。参与的儿科医生对 VFC 的总体看法进行了评分,范围从-5(高负担)到+5(高收益):63%的医生报告+4 或+5,23%的医生报告+1 到+3,5%的医生报告 0,9%的医生报告-1 到-5。39%的儿科医生报告意识到 VFC 疫苗接种的临时增加付款。其中,10%的医生报告说,根据这一变化,他们增加了为符合医疗补助和/或 VFC 资格的患者提供服务的比例。

结论

对大多数儿科医生来说,参与 VFC 的好处远远超过了负担。为了确保该计划的持续成功,重要的是要监测影响提供者参与的因素。

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