Association between medicaid reimbursement and child influenza vaccination rates

Byung Kwang Yoo, Andrea Berry, Megumi Kasajima, Peter G. Szilagyi

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

OBJECTIVE: We examined associations between influenza vaccination rates and Medicaid reimbursement rates for vaccine administration among poor children who were eligible for Medicaid (<100% of the federal poverty level in all states). METHODS: We analyzed 3 consecutive National Immunization Surveys (NISs) to assess influenza vaccination rates among nationally representative children 6 to 23 months of age during the 2005-2006 (unweighted N = 12 885), 2006 -2007 (unweighted N = 9238), and 2007-2008 (unweighted N = 11 785) influenza seasons (weighted N = 3.3- 4.0 million per season). We categorized children into 3 income levels (poor, near-poor, or nonpoor). We performed analyses with full influenza vaccination as the dependent variable and state Medicaid reimbursement rates (continuous covariate ranging from $2 to $17.86 per vaccination) and terms with income levels as key covariates. RESULTS: In total, 21.0%, 21.3%, and 28.9% of all US children and 11.7%, 11.6%, and 18.8% of poor children were fully vaccinated in the 2006, 2007, and 2008 NISs, respectively. Multivariate analyses of all 3 seasons found positive significant (all P<.05) associations between state-level Medicaid reimbursement and influenza vaccination rates among poor children. A $10 increase, from $8 per influenza vaccination (the US average) to $18 (the highest state reimbursement), in the Medicaid reimbursement rate was associated with 6.0-, 9.2-, and 6.4-percentage point increases in full vaccination rates among poor children in the 2006, 2007, and 2008 NIS analyses, respectively. CONCLUSION: Medicaid reimbursement rates are strongly associated with influenza vaccination rates.

Original languageEnglish (US)
JournalPediatrics
Volume126
Issue number5
DOIs
StatePublished - Nov 2010
Externally publishedYes

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Medicaid
Human Influenza
Vaccination
Immunization
Poverty
Vaccines
Multivariate Analysis

Keywords

  • Influenza vaccination
  • Medicaid reimbursement

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Association between medicaid reimbursement and child influenza vaccination rates. / Yoo, Byung Kwang; Berry, Andrea; Kasajima, Megumi; Szilagyi, Peter G.

In: Pediatrics, Vol. 126, No. 5, 11.2010.

Research output: Contribution to journalArticle

Yoo, Byung Kwang ; Berry, Andrea ; Kasajima, Megumi ; Szilagyi, Peter G. / Association between medicaid reimbursement and child influenza vaccination rates. In: Pediatrics. 2010 ; Vol. 126, No. 5.
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abstract = "OBJECTIVE: We examined associations between influenza vaccination rates and Medicaid reimbursement rates for vaccine administration among poor children who were eligible for Medicaid (<100{\%} of the federal poverty level in all states). METHODS: We analyzed 3 consecutive National Immunization Surveys (NISs) to assess influenza vaccination rates among nationally representative children 6 to 23 months of age during the 2005-2006 (unweighted N = 12 885), 2006 -2007 (unweighted N = 9238), and 2007-2008 (unweighted N = 11 785) influenza seasons (weighted N = 3.3- 4.0 million per season). We categorized children into 3 income levels (poor, near-poor, or nonpoor). We performed analyses with full influenza vaccination as the dependent variable and state Medicaid reimbursement rates (continuous covariate ranging from $2 to $17.86 per vaccination) and terms with income levels as key covariates. RESULTS: In total, 21.0{\%}, 21.3{\%}, and 28.9{\%} of all US children and 11.7{\%}, 11.6{\%}, and 18.8{\%} of poor children were fully vaccinated in the 2006, 2007, and 2008 NISs, respectively. Multivariate analyses of all 3 seasons found positive significant (all P<.05) associations between state-level Medicaid reimbursement and influenza vaccination rates among poor children. A $10 increase, from $8 per influenza vaccination (the US average) to $18 (the highest state reimbursement), in the Medicaid reimbursement rate was associated with 6.0-, 9.2-, and 6.4-percentage point increases in full vaccination rates among poor children in the 2006, 2007, and 2008 NIS analyses, respectively. CONCLUSION: Medicaid reimbursement rates are strongly associated with influenza vaccination rates.",
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N2 - OBJECTIVE: We examined associations between influenza vaccination rates and Medicaid reimbursement rates for vaccine administration among poor children who were eligible for Medicaid (<100% of the federal poverty level in all states). METHODS: We analyzed 3 consecutive National Immunization Surveys (NISs) to assess influenza vaccination rates among nationally representative children 6 to 23 months of age during the 2005-2006 (unweighted N = 12 885), 2006 -2007 (unweighted N = 9238), and 2007-2008 (unweighted N = 11 785) influenza seasons (weighted N = 3.3- 4.0 million per season). We categorized children into 3 income levels (poor, near-poor, or nonpoor). We performed analyses with full influenza vaccination as the dependent variable and state Medicaid reimbursement rates (continuous covariate ranging from $2 to $17.86 per vaccination) and terms with income levels as key covariates. RESULTS: In total, 21.0%, 21.3%, and 28.9% of all US children and 11.7%, 11.6%, and 18.8% of poor children were fully vaccinated in the 2006, 2007, and 2008 NISs, respectively. Multivariate analyses of all 3 seasons found positive significant (all P<.05) associations between state-level Medicaid reimbursement and influenza vaccination rates among poor children. A $10 increase, from $8 per influenza vaccination (the US average) to $18 (the highest state reimbursement), in the Medicaid reimbursement rate was associated with 6.0-, 9.2-, and 6.4-percentage point increases in full vaccination rates among poor children in the 2006, 2007, and 2008 NIS analyses, respectively. CONCLUSION: Medicaid reimbursement rates are strongly associated with influenza vaccination rates.

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