Access to Infant Immunizations for Poor, Inner-City Families

What Is the Impact of Managed Care?

Published In: Journal of Health Care For the Poor and Underserved, v. 5, no. 2, 1994, p. 112-123

Posted on RAND.org on January 01, 1994

by David L. Wood, Neal Halfon, Cathy D. Sherbourne, Mark Grabowsky

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Looks at the impact of managed care in terms of access to infant immunizations for poor, inner-city families. The study was based upon a survey of 867 families in two inner-city areas of Los Angeles. It assessed the relationship between insurance type, source of care, and access to immunization services. Compared to children in public health clinics, those receiving care in private physicians' offices or health maintenance organizations had odds of being up-to-date on immunizations of 0.43 and 0.24, respectively. These findings led the authors of the study to conclude that in the absence of meaningful financial incentives to encourage private physicians and HMOs to provide immunizations to inner-city children, managed care is unlikely to improve immunization rates among this vulnerable population. Enrolling children in managed care plans, such as is being contemplated in California for half its Medicaid population, will not have the expected impact of increasing immunizations unless attention is paid to this issue.

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