Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009

Zhou, Fangjun; Shefer, Abigail; Wenger, Jay D.; Messonnier, Mark L.; Wang, Li Yan; Lopez, Adriana; Moore, Matthew R.; Murphy, Trudy V.; Cortese, Margaret M.; Rodewald, Lance

doi:10.1542/peds.2013-0698

Cited by 223 publications

(161 citation statements)

References 57 publications

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“…They have been shown to be among the most costeffective health care interventions [29,30] and are estimated to have contributed significantly to reductions in morbidity and mortality. First, it has demonstrated the value and importance of examining within each group, as well as among groups, with groups being differentiated on the basis of race and ethnicity and income.…”

Section: Discussionmentioning

confidence: 99%

Since The Start Of The Vaccines For Children Program, Uptake Has Increased, And Most Disparities Have Decreased

2016

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This is the accepted version of the paper.This version of the publication may differ from the final published version. University of Ireland Galway. Permanent AbstractThe Vaccines for Children program is a US government intervention aimed at increasing vaccination uptake by removing financial barriers that may prevent American children from accessing vaccinations. This study examined the impact that this intervention had on race-and ethnicity-related and income-related disparities for diphtheria-tetanus-acellular pertussis,

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Section: Discussionmentioning

confidence: 99%

Since The Start Of The Vaccines For Children Program, Uptake Has Increased, And Most Disparities Have Decreased

2016

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“…Spreadsheet-based estimates often rely heavily on multiple published studies; therefore, spreadsheet and literature-based estimates represent a continuum of new calculations and use of modeled estimates from others. For example, our estimate for childhood immunizations-a literature-based estimate-uses model estimates from 2 other studies of the events prevented 19 and the cost-savings, 20 but uses information from additional sources to estimate QALYs saved and the costs of the vaccination series. Summaries of the methods for services are available online.…”

Section: Measures and Estimationmentioning

confidence: 99%

Updated Priorities Among Effective Clinical Preventive Services

et al. 2017

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PURPOSEThe Patient Protection and Affordable Care Act's provisions for firstdollar coverage of evidence-based preventive services have reduced an important barrier to receipt of preventive care. Safety-net providers, however, still serve a substantial uninsured population, and clinician and patient time remain limited in all primary care settings. As a consequence, decision makers continue to set priorities to help focus their efforts. This report updates estimates of relative health impact and cost-effectiveness for evidence-based preventive services. METHODSWe assessed the potential impact of 28 evidence-based clinical preventive services in terms of their cost-effectiveness and clinically preventable burden, as measured by quality-adjusted life years (QALYs) saved. Each service received 1 to 5 points on each of the 2 measures-cost-effectiveness and clinically preventable burden-for a total score ranging from 2 to 10. New microsimulation models were used to provide updated estimates of 12 of these services. Priorities for improving delivery rates were established by comparing the ranking with what is known of current delivery rates nationally. RESULTSThe 3 highest-ranking services, each with a total score of 10, are immunizing children, counseling to prevent tobacco initiation among youth, and tobacco-use screening and brief intervention to encourage cessation among adults. Greatest population health improvement could be obtained from increasing utilization of clinical preventive services that address tobacco use, obesityrelated behaviors, and alcohol misuse, as well as colorectal cancer screening and influenza vaccinations.CONCLUSIONS This study identifies high-priority preventive services and should help decision makers select which services to emphasize in quality-improvement initiatives. 2017;15:14-22. https://doi.org/10.1370/afm.2017. Ann Fam Med INTRODUCTIONT he landscape for prevention in primary care has changed dramatically since the Committee on Clinical Preventive Service Priorities published the first ranking of clinical preventive services in 2001, 1 and the National Commission on Prevention Priorities (NCPP) last updated the list in 2006. 2 A growing evidence base has expanded knowledge about effective preventive services. At the same time, the Patient Protection and Affordable Care Act (ACA) and the pursuit of the Triple Aim 3 seek to expand access to and the efficiency of primary care.Changes in primary care have potential to improve utilization of preventive services. Patient-centered medical homes (PCMHs) have been associated with increased use of preventive services, though it is not clear whether health and financial outcomes are affected. [4][5][6] Accountable Care Organizations (ACOs), when combined with PCMHs, may empower primary care and incentivize change, 7 and ACO shared-savings contracts may encourage hospital systems and specialty providers to become vested stakeholders in evidence-based prevention. Preventive care quality measures and incentives in ACO contracts might ass...

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“…Each year, vaccinations save thousands of lives and result in substantial cost savings. 1,2 Although vaccination is an important cornerstone of routine pediatric care, a substantial proportion of US children remain susceptible to serious, vaccinepreventable diseases.…”

Section: What This Study Addsmentioning

confidence: 99%

Childhood Vaccination Coverage Rates Among Military Dependents in the United States

et al. 2015

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BACKGROUND AND OBJECTIVES: The Military Health System provides universal coverage of all recommended childhood vaccinations. Few studies have examined the effect that being insured by the Military Health System has on childhood vaccination coverage. The purpose of this study was to compare the coverage of the universally recommended vaccines among military dependents versus other insured and uninsured children using a nationwide sample of children. METHODS: The National Immunization Survey is a multistage, random-digit dialing survey designed to measure vaccination coverage estimates of US children aged 19 to 35 months old. Data from 2007 through 2012 were combined to permit comparison of vaccination coverage among military dependent and all other children. RESULTS: Among military dependents, 28.0% of children aged 19 to 35 months were not up to date on the 4:3:1:3:3:1 vaccination series excluding Haemophilus influenzae type b vaccine compared with 21.1% of all other children (odds ratio: 1.4; 95% confidence interval: 1.2–1.6). After controlling for sociodemographic characteristics, compared with all other US children, military dependent children were more likely to be incompletely vaccinated (odds ratio: 1.3; 95% confidence interval: 1.1–1.5). CONCLUSIONS: Lower vaccination coverage rates among US military dependent children might be due to this population being highly mobile. However, the lack of a military-wide childhood immunization registry and incomplete documentation of vaccinations could contribute to the lower vaccination coverage rates seen in this study. These results suggest the need for further investigation to evaluate vaccination coverage of children with complete ascertainment of vaccination history, and if lower immunization rates are verified, assessment of reasons for lower vaccination coverage rates among military dependent children.

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Economic Evaluation of the Routine Childhood Immunization Program in the United States, 2009

Cited by 223 publications

References 57 publications

Since The Start Of The Vaccines For Children Program, Uptake Has Increased, And Most Disparities Have Decreased

Since The Start Of The Vaccines For Children Program, Uptake Has Increased, And Most Disparities Have Decreased

Updated Priorities Among Effective Clinical Preventive Services

Childhood Vaccination Coverage Rates Among Military Dependents in the United States

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