KEYWORDS:
infant vaccination, barriers to vaccination, physician practice revenue

BACKGROUND:
The increased number of recommended infant vaccine injections has led to an increased number of vaccine injections which may be concurrently due at an office visit. Since parents and clinicians are reluctant to have too many injections simultaneously administered, some are deferred to subsequent visits, not all of which occur, leading to decreased vaccine seroprotection and increased infectious disease. While combination vaccine use may avoid these epidemiologic effects, their use may be constrained by effects on physician practice revenue. Physicians are paid per vaccine injection, and thus administration fee revenue would be reduced. Yet combination vaccine use may also lead to reduced vaccination visits, as fewer injections will be deferred, which would permit increased revenue from additional non-vaccination visits.

OBJECTIVE(S):
To estimate the effects of DTPa-HBV-IPV on number of visits and physician practice revenue.

METHOD(S):
Vaccination records of 600 children born in 2001 were reviewed from 24 pediatrician and FP/GP practices. A set of heuristics were developed to estimate how DTPa-HBV-IPV may be substituted for individual DTPa, HBV, and/or IPV injections. Through applying these heuristics to the records, vaccination visits which may be made unnecessary were counted. These reduced visits were assumed to be replaced by either a well- or sick-child visit, according to the distribution of such visits observed in the data set. Total revenue was compared, considering vaccine administration fees and increased visits.

RESULT(S):
Results will be available prior to the conference.

CONCLUSIONS(S):

LEARNING OBJECTIVES:
This study provides information describing the effects of infant combination vaccine use on physician revenue.