Cost of universal influenza vaccination of children in pediatric practices.
Cost of universal influenza vaccination of children in pediatric practices.
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DOI：
10.1542/peds.2009-1542i
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发表时间：
2009-12
期刊：
影响因子：
8
通讯作者：
Coleman MS
中科院分区：
文献类型：
--
作者：
Yoo BK;Szilagyi PG;Schaffer SJ;Humiston SG;Rand CM;Albertin CS;Vincelli P;Blumkin AK;Shone LP;Coleman MS
尽管现在建议所有6个月至18岁的儿童接种流感疫苗，但儿科接种儿童流感疫苗的直接和间接费用总额尚不清楚。估计2006 - 2007年流感季全国代表性儿科诊所提供流感疫苗接种的成本，并模拟美国6个月至18岁儿童实施通用流感疫苗接种时儿科诊所可能产生的成本。我们对纽约州儿科实践（n = 91）进行了分层随机抽样调查，以从医生和办公室经理那里获得与提供流感疫苗相关的所有实践资源的信息。我们估计了两种实践规模（小型，大型）和三个地理区域（城市，郊区，农村）的疫苗接种成本。我们对这些数据进行了调整，以获得国家估计值。为6个月至18岁的儿童提供一种流感疫苗的总实践成本（2006年美元）。在所有受访者中，每次疫苗接种的总成本中位数为28.62美元（范围为18.67美元（第25百分位数）至45.28美元（第75百分位数））。中位组成成本为：（1）临床人员/劳动力-2.01美元，（2）非临床人员/劳动力-7.96美元，（3）所有其他（管理费用）成本-10.43美元。疫苗购买费用平均为8.22美元。较小的做法和城市做法的成本高于较大的做法或郊区做法。假设所有符合儿童疫苗计划（VFC）条件的儿童的疫苗接种报销是目前医疗补助的中位数8.40美元，如果只有三分之一的儿童接种流感疫苗，那么通过提供VFC疫苗，美国所有儿科实践的财务损失将达到9800万美元。儿科诊所提供流感疫苗接种的总成本很高，因诊所特点而异，超过了VFC的平均报销。许多儿科实践可能面临财务风险，除非医疗补助和私人疫苗接种报销增加。
Although all children 6 months to 18 years are now recommended to receive influenza vaccine, the total direct and indirect costs for pediatric practices of delivering childhood influenza vaccination are unknown. To estimate nationally-representative pediatric practices’ costs of providing influenza vaccination during the 2006–2007 season, and to simulate the costs pediatric practices might incur when implementing universal influenza vaccination for US children 6 months to 18 years. We surveyed a stratified, random sample of New York State pediatric practices (n=91) to obtain information from physicians and office managers about all practice resources associated with provision of influenza vaccination. We estimated vaccination costs for two practice sizes (small, large) and three geographic areas (urban, suburban, rural). We adjusted these data to obtain national estimates. Total practice cost for providing one influenza vaccine (2006 dollars) to children 6 months to 18 years. Among all respondents, the median total cost per vaccination was $28.62 (range $18.67 (25th percentile) to $45.28 (75th percentile)). The median component costs were: (1) clinical personnel/labor- $2.01, (2) non-clinical personnel/labor- $7.96, and (3) all other (overhead) costs- $10.43. Vaccine purchase costs averaged $8.22. Smaller practices and urban practices had higher costs than larger or suburban practices. Assuming that vaccine administration reimbursement for all Vaccine For Children program (VFC) eligible children is the current Medicaid median of $8.40, the financial loss across all US pediatric practices through delivering VFC vaccines would be $98 million if only one-third of children received influenza vaccine. The total cost for pediatric practices to provide influenza vaccination is high, varies by practice characteristics, and exceeds average VFC reimbursement. Many pediatric practices may face financial risk unless both Medicaid and private vaccination reimbursement are increased.