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Delays in childhood immunizations in public and private settings
W J Hueston1, A G Mainous, C Palmer
1St Claire Medical Center, Morehead, Ky.
Insights
Children receiving immunizations from public health departments experienced more delays due to missed opportunities and invalid reasons compared to those using private providers. This highlights potential areas for improving childhood immunization rates.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Rising costs of childhood immunizations have led to increased reliance on public health departments.
- This study investigates factors contributing to immunization delays in public versus private healthcare settings.
Purpose of the Study:
- To compare the reasons for immunization delays between children receiving services from public health departments and private providers.
- To identify specific barriers to timely childhood immunizations in different healthcare systems.
Main Methods:
- A survey of birth certificates from children born between September 1988 and August 1989 in Kentucky was conducted in late 1991.
- The study analyzed the percentage of delayed immunizations and the associated reasons for children utilizing public health departments versus private physicians/clinics.
Main Results:
- Children utilizing public health departments or a mix of public/private sources were more likely to have delayed immunizations (56%) compared to those using private providers (34%).
- Publicly served patients experienced more delays due to invalid contraindications (34% vs 8%), missed appointments (22% vs 9%), and failure to receive immunizations during other visits (23% vs 11%).
Conclusions:
- Immunization delays are prevalent in both public and private healthcare settings.
- Public health services are associated with a higher likelihood of delays, particularly those stemming from missed opportunities and administrative issues.
Background:
As the costs of childhood immunizations have increased over the past 10 years, patients have increasingly turned to public health departments for this service. This study compares reasons for delays in immunization among patients who obtained their immunizations at health departments and those who continued to utilize private physicians or clinics.
Methods:
A birth certificate survey of all children born between September 1, 1988, and August 31, 1989, in four urban census tracts and two rural counties in Kentucky was performed in late 1991, when all children were over age 2 years. The percentage of patients whose immunizations had been delayed and the reasons for delay were noted.
Results:
Children who utilized public health departments or a combination of health departments and private sources for their immunizations were more likely to have experienced delays than those who obtained immunizations from private providers (56% vs 34%, P = .002). In particular, patients in the public provider group were more likely than those in the private provider group to have missed immunizations for invalid contraindications (34% vs 8%, P = .02), missed appointments (22% vs 9%, P = .02), or failure to receive immunizations when at the health department for another visit (23% vs 11%, P = .04).
Conclusions:
While a large number of patients in both the private and public provider groups experienced delays in immunizations, patients who received immunizations from public sources were more likely to experience delays related to missed opportunities.