Local health departments play an important role as providers of childhood immunizations; however, increasing costs and changes in the delivery of well child care have called into question to whom the public sector should provide immunizations. The Colorado Association of Local Public Health Leaders (CALPHL) commissioned a study to investigate who uses public childhood immunization clinics in Colorado and why. Eight local health departments in Colorado serving 65% of the state's population participated in this study. Ninety-one percent of all childhood immunization clinic users completed a brief self-administered anonymous survey during June, 2000. A total of 1468 surveys were completed. Fifty-four percent of respondents had either private (35%) or public (19%) health insurance coverage; 46% were uninsured. Seventy-five percent had a regular place for medical care. Among those with health insurance, 24% said their insurance covered the cost of immunizations, 44% said it did not, and 32% didn't know. The primary reasons respondents chose health department clinics were that it costs less then their doctor (21%), they did not have a doctor (21%), and convenience (15%). County subsidies accounted for 57% of the total costs of the immunization programs run by the health departments in this study. CALPHL is exploring several programmatic and policy interventions including educating insured clinic users about their immunization coverage, linking those without a medical home to an on-going source of primary care, and instituting a "first dollar coverage" law to require that all childhood immunizations are covered by insurance before deductible and co-pays are applied.
Learning Objectives: 1. Describe three barriers inherent in the current immunization delivery system which prevent all children from being adequately immunized. 2. Construct a collaborative process for assessing key features of public childhood immunization clinic utilization. 3. Identify five policy and programmatic interventions to decrease inappropriate use of public immunization clinics.
Keywords: Immunizations, Policy/Policy Development
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Colorado Association of Local Public Health Leaders (CALPHL)