Article Figures & Data
Figures
- Figure 1.
Claims rates for influenza immunization from the same physician, another clinician, or no clinician, by year.
Annual median percentages of fee-for-service Medicare beneficiaries =65 years with claims for influenza immunization the previous year having current year claims from the same physician, another clinician, or no claim. Figure is based on claims reported to the Centers for Medicare & Medicaid Services by unique physician identifying numbers for West Virginia and includes physicians claiming at least 25 immunizations between September 1 and December 31 of each year. The percentages represent the median for each indicator across all such physicians in a given year.
Tables
- Table 1.
Specialty Distribution of West Virginia Physicians Providing Influenza Immunization, 2004
Specialty No. % Note: West Virginia physicians with at least 25 claims for influenza immunization between September 1 and December 31, 2004, for Medicare fee-for-service beneficiaries aged =65 years. Specialties are the first listed specialty reported to Centers for Medicare & Medicaid Services. General practice 72 9.0 Internal medicine 301 37.7 Family practice 246 30.8 Other specialty 119 14.9 Unknown 61 7.6 Total 799 100.0 - Table 2.
West Virginia Physicians with Medicare Claims for Influenza Immunization, 1999–2004
No. of Physicians With at Least Year 1 Claim 25 Claims Total Claims No. Average Claims per Physician No. Note: Claims for fee-for-service beneficiaries aged =65 years, 1999–2004. 1999 2,773 849 97,538 35.2 2000 2,514 724 80,519 32.0 2001 2,578 723 85,442 33.1 2002 2,603 786 88,938 34.2 2003 2,921 799 92,360 31.6 2004 2,051 379 43,914 21.4 - Table 3.
Claims for Influenza Immunization Among West Virginia Medicare Beneficiaries Aged 65 Years and Older, by Provider Type, 1999–2004
Provider Type 1999 No. (%) 2000 No. (%) 2001 No. (%) 2002 No. (%) 2003 No. (%) 2004 No. (%) Hospital 3,681 (3.6) 4,515 (5.1) 5,468 (5.8) 3,905 (3.9) 5,033 (5.0) 6,071 (9.2) Home health 1,400 (1.4) 437 (0.5) 1,522 (1.6) 725 (0.7) 1,492 (1.5) 1,784 (2.7) Nursing home 2,556 (2.5) 2,424 (2.8) 2,461 (2.6) 2,491 (2.5) 2,700 (2.7) 1,957 (3.0) Other Part A 2,066 (2.0) 1,838 (2.1) 857 (0.9) 757 (0.7) 932 (.9) 1,064 (1.6) Physician 83,391 (81.3) 66,648 (75.9) 71,594 (76.5) 80,233 (79.3) 77,065 (77.2) 33,407 (50.6) Mass vaccinator 8,957 (8.7) 11,369 (13.0) 10,838 (11.6) 11,781 (11.7) 11,063 (11.1) 20,559 (31.2) Other Part B 383 (0.4) 377 (0.4) 773 (0.8) 1,101 (1.1) 1,356 (1.4) 758 (1.1) Unknown 136 (0.1) 152 (0.2) 98 (0.1) 121 (0.1) 199 (0.2) 381 (0.6) Total 102,570 (100) 87,760 (100) 93,611 (100) 101,114 (100) 99,840 (100) 65,981 (100) - Table 4.
Mass Vaccinator Clinicians and Claims, West Virginia Medicare Claims for Influenza Immunization, 1999–2004
Clinicians Claims Year Total No. Larger* No. Total No. Larger* No. (%) *At least 100 claims in a given year. 1999 139 20 8,957 8,279 (92.4) 2000 155 19 11,369 10,314 (90.7) 2001 135 23 10,838 10,138 (93.5) 2002 155 27 11,781 10,866 (92.2) 2003 164 23 11,063 10,040 (90.8) 2004 202 29 20,559 19,379 (94.3) Year Claims* % BRFSS† % Lagged Prediction‡ % Estimated Nonbilling§ % Note: BRFSS = Behavioral Risk Factor Surveillance System. * Claims represent proportion of Medicare beneficiaries =65 years who had claims for influenza vaccine between September 1 of the indicated year and January 31 of the subsequent year. † BRFSS is the proportion of the West Virginia population =65 years who indicated having an influenza immunization in the previous 12 months during the indicated year. ‡ Lagged prediction is the predicted true proportion of the West Virginia population =65 years who received influenza immunization, based on the following year’s BRFSS results, with a sensitivity of 0.98 and specificity of 0.71, after MacDonald et al.27 § Estimated nonbilling is the difference between the lagged prediction and the claims rates of influenza immunization. 1993 – 49.8 – – 1994 35.7 – 35.1 −0.6 1995 37.1 53.2 – – 1996 37.0 – 42.3 5.3 1997 39.1 58.2 49.1 10.0 1998 39.4 62.9 49.1 9.7 1999 42.5 62.9 – – 2000 36.5 – 47.4 10.9 2001 38.9 61.7 53.3 14.4 2002 41.8 65.8 58.1 16.3 2003 41.2 69.1 56.4 15.2 2004 27.1 67.9 50.1 23.1 2005 – 63.6 – –
The Article in Brief
Impact of the 2004 Influenza Vaccine Shortage on Repeat Immunization Rates
By Charles P. Schade, MD, MPH, and colleague
Background In 2004, there was a severe shortage of influenza (flu) vaccine in the United States. As a result, it was recommended that doctors give flu vaccinations only to people in high-risk groups. This study examines Medicare data in West Virginia to determine how doctors and patients were affected by the shortage of flu vaccines.
What This Study Found In 2004, total Medicare claims for flu vaccinations in West Virginia dropped by more than 50%, from more than 92,000 in 2003 to approximately 44,000 in 2004. Some patients received vaccines from sources other than their regular doctors, most often from a mass immunizer (an organization such as a public health clinic or pharmacy that offers vaccinations to large numbers of people). The number of Medicare beneficiaries receiving a flu vaccine fell by about 8% in 2004 compared with previous years. The percentage of Medicare recipients who received flu vaccine from the same clinician as the year before fell from 54% in 2002-2003 to 3% in 2003-2004.
Implications
- The 2004 vaccine shortage severely affected the ability of doctors to provide flu immunizations, an important preventive health service, to their patients.
- The shortage also appeared to disrupt the ongoing relationship between patients and doctors.
- Those who did not receive immunizations were most likely people who lacked transportation or were too ill to locate a different source of flu vaccine.
