Impact of vaccine economic programs on physician referral of children to public vaccine clinics: a pre-post comparison

BACKGROUND: The Vaccines for Children (VFC) Program is a major vaccine entitlement program with limited long-term evaluation. The objectives of this study are to evaluate the effect of VFC on physician reported referral of children to public health clinics and on doses administered in the public sector. METHODS: Minnesota and Pennsylvania primary care physicians (n = 164), completed surveys before (e.g., 1993) and after (2003) VFC, rating their likelihood on a scale of 0 (very unlikely) to 10 (very likely) of referring a child to the health department for immunization. RESULTS: The percentage of respondents likely to refer was 60% for an uninsured child, 14% for a child with Medicaid, and 3% for a child with insurance that pays for immunization. Half (55%) of the physicians who did not participate in VFC were likely to refer a Medicaid-insured child, as compared with 6% of those who participated (P < 0.001). Physician likelihood to refer an uninsured child for vaccination, measured on a scale of 0 to 10 where 10 is very likely, decreased by a mean difference of 1.9 (P < 0.001) from pre- to post-VFC. The likelihood to refer a Medicaid-insured child decreased by a mean of 1.2 (P = 0.001). CONCLUSION: Reported out-referral to public clinics decreased over time. In light of increasing immunizations rates, this suggests that more vaccines were being administered in private provider offices

Conceptual frameworks and empirical approaches used to assess the impact of health research: an overview of reviews

<p>Abstract</p> <p>Background</p> <p>How to assess the impact of research is of growing interest to funders, policy makers and researchers mainly to understand the value of investments and to increase accountability. Broadly speaking the term "research impact" refers to the contribution of research activities to achieve desired societal outcomes. The aim of this overview is to identify the most common approaches to research impact assessment, categories of impact and their respective indicators.</p> <p>Methods</p> <p>We systematically searched the relevant literature (PubMed, The Cochrane Library (1990-2009)) and funding agency websites. We included systematic reviews, theoretical and methodological papers, and empirical case-studies on how to evaluate research impact. We qualitatively summarised the included reports, as well the conceptual frameworks.</p> <p>Results</p> <p>We identified twenty-two reports belonging to four systematic reviews and 14 primary studies. These publications reported several theoretical frameworks and methodological approaches (bibliometrics, econometrics, ad hoc case studies). The "payback model" emerged as the most frequently used. Five broad categories of impact were identified: a) advancing knowledge, b) capacity building, c) informing decision-making, d) health benefits, e) broad socio-economic benefits. For each proposed category of impact we summarized a set of indicators whose pros and cons are presented and briefly discussed.</p> <p>Conclusions</p> <p>This overview is a comprehensive, yet descriptive, contribution to summarize the conceptual framework and taxonomy of an heterogeneous and evolving area of research. A shared and comprehensive conceptual framework does not seem to be available yet and its single components (epidemiologic, economic, and social) are often valued differently in different models.</p

Results of the 2014 Eagle Marsh Biodiversity Survey, Allen County, Indiana

ABSTRACT. Eagle Marsh, a 289.8 ha (716-acre) wetland nature preserve located on the southwest border of Fort Wayne, Indiana, is one of the largest wetland restorations ever undertaken in Indiana. The Little River Wetlands Project (LRWP) began acquisition, planning, and restoration in 2005 to 2007. The first biodiversity survey (also known as a bioblitz) of Eagle Marsh was conducted on 31 May and 1 June 2014. Over 125 scientists, naturalists, students, and other volunteers on thirteen different taxonomic teams observed and reported 728 taxa during the event. The thirteen taxonomic teams included aquatic macroinvertebrates, beetles, birds, butterflies, dragonflies and damselflies, fish, freshwater mussels, herpetofauna, small mammals, mushrooms/fungi, singing insects, snail-killing flies, and vascular plants. This manuscript presents both a brief history of Eagle Marsh and a summary overview of the results gathered by the thirteen taxonomic teams