Early Continuity of Care and Immunization Coverage

Irigoyen, Matilde; Findley, Sally E.; Chen, Shaofu; Vaughan, Roger; Sternfels, Pamela; Caesar, Arturo; Metroka, Amy

doi:10.1367/a03-138r1.1

Cited by 18 publications

(14 citation statements)

References 28 publications

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“…Irigoyen et al 8 found in a study of 641 inner-city children that children who remained with their initial source of medical care the longest were more likely to stay current on immunizations. Smith et al 12 examined UTD coverage for 19-to 35-month-old VFC-eligible children who had a medical home, which was defined as having a doctor, nurse, or physician's assistant who provided routine ongoing care.…”

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

“…[8][9][10] However, only a few have created a definition of the medical home to examine how this factor influences vaccination coverage. 8,11,12 The association between type of health insurance and continuity of insurance coverage with vaccination coverage have also been evaluated. [13][14][15][16][17] However, most of the studies examining health insurance coverage have looked at how the presence or absence of insurance affected vaccination coverage but were not able to take into account the effect of insurance lapses on vaccination rates.…”

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confidence: 99%

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The Association of Health Insurance and Continuous Primary Care in the Medical Home on Vaccination Coverage for 19- to 35-Month-Old Children

2007

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OBJECTIVE. Our goal was to examine the association of continuous care in the medical home and health insurance on up-to-date vaccination coverage by using data from the National Survey of Children's Health and the National Immunization Survey. METHODS. Interviews were conducted with 5400 parents of 19- to 35-month-old children to collect data on demographics and medically-verified vaccinations. Health insurance coverage was categorized as always, intermittently, or uninsured for the previous 12 months. Insurance types were private, public, or uninsured. Having a personal doctor or nurse and receiving preventive health care in either the past 12 or 24 months constituted continuous primary care in the medical home. Children were up-to-date if they received all vaccinations by 19 to 35 months of age (≥4 doses of diphtheria and tetanus toxoids and pertussis vaccine, ≥3 doses of poliovirus vaccine, ≥1 dose of any measles-containing vaccine, ≥3 doses of Haemophilus influenzae type b vaccine, and ≥3 doses of hepatitis B vaccine). RESULTS. Bivariate analyses revealed children who were always insured had significantly higher vaccination coverage (83%) than those with lapses or uninsured during the past 12 months (75% and 71%, respectively). Those with continuous primary care in the medical home had significantly higher coverage than those who did not (83% vs 75%, respectively). In multivariate analysis, the same pattern of association was observed for insurance status and medical home, but the only statistically significant association was for children of never-married mothers who had significantly lower coverage (74%) compared with children of married mothers (84%). CONCLUSIONS. Among children with the same insurance status and continuity of care in the medical home, children of single mothers were less likely to be up-to-date than children of married mothers. Interventions assisting single mothers to obtain preventive care for their children should be a priority.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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The Association of Health Insurance and Continuous Primary Care in the Medical Home on Vaccination Coverage for 19- to 35-Month-Old Children

2007

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“…Although some studies have included all children, it was unclear if the positive associations found were due solely to the effect of CSHCN in the study populations, or if they exist independent of CSHCN. 12,[30][31][32][33][34][35][36][37][38][39][40][41] Our findings suggest that the benefits of the medical home for children without special health care needs mirror those experienced by CSHCN.…”

Section: Discussionmentioning

confidence: 89%

“…Previous studies have focused on clinical outcomes such as ED utilization 5,6,32,34,37 and immunizations. 30,31,33,[35][36][37][39][40][41] The medical home concept, however, is explicitly designed to provide care for all aspects of a child' s health and well-being. 1 We therefore selected health-promoting behavior outcomes previously demonstrated to be positively associated with child health.…”

Section: Discussionmentioning

confidence: 99%