Patterns of Primary Care Physician Visits for US Adolescents in 2014: Implications for Vaccination

Rand, Cynthia M.; Goldstein, Nicolas P.N.

doi:10.1016/j.acap.2018.01.002

Cited by 120 publications

(78 citation statements)

References 29 publications

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“…As such, these children age over time and require less frequent preventive visits as they age . Children are also less likely to have any primary care visits as they age . This may also reflect a broader trend in declining office visit rates…”

Section: Discussionmentioning

confidence: 99%

“…58 Children are also less likely to have any primary care visits as they age. 59 This may also reflect a broader trend in declining office visit rates. 60 Additionally, while our sensitivity analyses using propensity matching suggest that TEAM UP was associated with marginal increases in primary care visits and decreases in non-primary care outpatient visits, thereby suggesting a potential substitution effect, as well as decreases total cost of care, because these results are not robust to specification, we cannot conclude any effect on these outcomes.…”

Section: Discussionmentioning

confidence: 99%

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The effects of integrating behavioral health into primary care for low‐income children

Cole

Qin²,

Sheldrick

et al. 2019

Health Services Research

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Objective To evaluate the impact of TEAM UP—an initiative that fully integrates behavioral health services into pediatric primary care in three Boston‐area Community Health Centers (CHCs)—on health care utilization and costs. Data Sources 2014‐2017 claims data on continuously enrolled children from a Massachusetts Medicaid managed care plan. Study Design We used a difference‐in‐difference approach with inverse probability of treatment weights to compare outcomes in children receiving primary care at TEAM UP CHCs versus comparison site CHCs, in the pre (2014‐2016q2)‐ versus post (2016q3‐2017)‐intervention periods. Utilization outcomes included emergency department visits, inpatient admissions, primary care visits, and outpatient/professional visits (all cause and those with mental health (MH) diagnoses). Cost outcomes included total cost of care (inpatient, outpatient, professional, pharmacy). We further assessed differential effects by baseline MH diagnosis. Principal Findings After 1.5 years, TEAM UP was associated with a relative increase in the rate of primary care visits (IRR = 1.15, 95% CI 1.04‐1.27, or 115 additional visits/1000 patients/quarter), driven by children with a MH diagnosis at baseline. There was no significant change in avoidable health care utilization or cost. Conclusions Expanding the TEAM UP behavioral health integration model to other sites has the potential to improve primary care engagement in low‐income children with MH needs.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The effects of integrating behavioral health into primary care for low‐income children

Cole

Qin²,

Sheldrick

et al. 2019

Health Services Research

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show abstract

“…Despite ACIP recommendations regarding MenB vaccination, there remain a number of barriers to immunization in adolescents and young adults, including cost (real or perceived), supply and a lack of vaccination opportunities . Compared with younger children, older adolescents generally have fewer primary care visits and more visits with specialists, who are less focused on vaccination . There are also a number of potential provider‐related barriers to immunization, including knowledge gaps with respect to vaccine indications and recommendations, and poor communication with parents and/or adolescents .…”

Section: What Is New and Conclusionmentioning

confidence: 99%

“…82 Compared with younger children, older adolescents generally have fewer primary care visits and more visits with specialists, who are less focused on vaccination. 84,85 There are also a number of potential provider-related barriers to immunization, including knowledge gaps with respect to vaccine indications and recommendations, and poor communication with parents and/or adolescents. 82 Healthcare policies for vaccination may play a key role in overcoming barriers to vaccination, 86 In practice, the pharmacist may be presented with a variety of cases in which this individual decision-making (previously Category B) recommendation for MenB vaccination may apply; therefore, pharmacists must ensure that vaccination screening includes the adolescent/young adult age group.…”

Section: Vaccine Storage and Administrationmentioning

confidence: 99%

A review of the immunogenicity, safety and current recommendations for the meningococcal serogroup B vaccine, MenB‐FHbp

Alderfer

Snow

2019

J Clin Pharm Ther

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What is known and objective This review describes invasive meningococcal disease (IMD) epidemiology in the United States, provides a brief overview of available meningococcal vaccines and discusses meningococcal serogroup B (MenB) vaccine development. Particular focus is given to the recombinant protein MenB vaccine, MenB‐FHbp (Trumenba®, bivalent rLP2086) in light of recent publication of phase 3 data; the other MenB vaccine (Bexsero®, MenB‐4C) has been recently reviewed. Current recommendations of the US Advisory Committee on Immunization Practices (ACIP) for MenB vaccination and potential barriers to immunization are also discussed. Methods Using the published literature, this article reviews the development and use of MenB‐FHbp to date, with a focus on the United States. Results and discussion Despite the availability of medical treatment, IMD is associated with significant mortality and frequently occurring serious permanent sequelae in surviving individuals. Worldwide, most IMD is caused by six serogroups (A, B, C, W, X and Y). MenB is the most common disease‐causing meningococcal serogroup in the United States and has caused several recent university‐based IMD outbreaks. MenB vaccines, including MenB‐FHbp, are available in the United States. ACIP recommends that all individuals ≥10 years of age at increased risk for meningococcal disease receive MenB vaccination; healthy individuals 16‐23 years of age are recommended MenB vaccines based on individual clinical decision‐making. MenB‐FHbp is used on a 2‐dose schedule (0, 6 months) when vaccinating healthy individuals and on a tailored 3‐dose schedule (0, 1‒2, 6 months) in cases of increased risk. What is new and conclusion Because vaccination provides the most effective protection against IMD, pharmacists are in an excellent position to offer evidence‐based vaccine information, as well as to encourage and provide meningococcal immunizations to adolescents and young adults.

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“…In the final section, systems perspectives, Rand and Goldstein 11 provide an overview of health care utilization among individuals ages 9 to 21 years to highlight how often eligible children and adolescents “touch” the health care system and therefore have opportunities for vaccination. Only 35% made a preventive health care visit during the past 12 months with visits decreasing after age 16 years, highlighting the importance of taking advantage of every health care encounter and providing HPV vaccine at the recommended age of 11 to 12 years.…”

mentioning

confidence: 99%

Improving Human Papillomavirus Vaccination in the United States: Executive Summary

Stokley

Szilâgyi

2018

Academic Pediatrics

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Patterns of Primary Care Physician Visits for US Adolescents in 2014: Implications for Vaccination

Cited by 120 publications

References 29 publications

The effects of integrating behavioral health into primary care for low‐income children

The effects of integrating behavioral health into primary care for low‐income children

A review of the immunogenicity, safety and current recommendations for the meningococcal serogroup B vaccine, MenB‐FHbp

Improving Human Papillomavirus Vaccination in the United States: Executive Summary

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