Influenza Vaccinations Among Privately and Publicly Insured Children With Asthma.

Autor: Geissler KH; Department of Health Promotion and Policy (KH Geissler, V Evans, and SL Goff), School of Public Health & Health Sciences, University of Massachusetts Amherst. Electronic address: kgeissler@umass.edu., Shieh MS; Department of Healthcare Delivery and Population Sciences (M-S Shieh and PK Lindenauer), University of Massachusetts Chan Medical School-Baystate, Springfield, MA., Evans V; Department of Health Promotion and Policy (KH Geissler, V Evans, and SL Goff), School of Public Health & Health Sciences, University of Massachusetts Amherst., Lindenauer PK; Department of Healthcare Delivery and Population Sciences (M-S Shieh and PK Lindenauer), University of Massachusetts Chan Medical School-Baystate, Springfield, MA; Department of Medicine (PK Lindenauer), University of Massachusetts Chan Medical School-Baystate, Springfield, MA., Ash AS; Department of Population and Quantitative Health Sciences (AS Ash), UMass Chan Medical School, Worcester, MA., Krishnan JA; Division of Epidemiology and Biostatistics (JA Krishnan), School of Public Health, University of Illinois Chicago; Division of Pulmonary, Critical Care, Sleep and Allergy (JA Krishnan), College of Medicine, University of Illinois Chicago; Institute for Healthcare Delivery Design (JA Krishnan), University of Illinois Chicago., Goff SL; Department of Health Promotion and Policy (KH Geissler, V Evans, and SL Goff), School of Public Health & Health Sciences, University of Massachusetts Amherst.
Jazyk: angličtina
Zdroj: Academic pediatrics [Acad Pediatr] 2023 Sep-Oct; Vol. 23 (7), pp. 1368-1375. Date of Electronic Publication: 2023 Mar 02.
DOI: 10.1016/j.acap.2023.02.010
Abstrakt: Objective: Annual influenza vaccination rates for children remain well below the Healthy People 2030 target of 70%. We aimed to compare influenza vaccination rates for children with asthma by insurance type and to identify associated factors.
Methods: This cross-sectional study examined influenza vaccination rates for children with asthma by insurance type, age, year, and disease status using the Massachusetts All Payer Claims Database (2014-2018). We used multivariable logistic regression to estimate the probability of vaccination accounting for child and insurance characteristics.
Results: The sample included 317,596 child-year observations for children with asthma in 2015-18. Fewer than half of children with asthma received influenza vaccinations; 51.3% among privately insured and 45.1% among Medicaid insured. Risk modeling reduced, but did not eliminate, this gap; privately insured children were 3.7 percentage points (pp) more likely to receive an influenza vaccination than Medicaid-insured children (95% confidence interval [CI]: 2.9-4.5pp). Risk modeling also found persistent asthma was associated with more vaccinations (6.7pp higher; 95% CI: 6.2-7.2pp), as was younger age. The regression-adjusted probability of influenza vaccination in a non-office setting was 3.2pp higher in 2018 than 2015 (95% CI: 2.2-4.2pp), and significantly lower for children with Medicaid.
Conclusions: Despite clear recommendations for annual influenza vaccinations for children with asthma, low rates persist, particularly for children with Medicaid. Offering vaccines in non-office settings such as retail pharmacies may reduce barriers, but we did not observe increased vaccination rates in the first years after this policy change.
(Copyright © 2023 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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