When Data Don’t Cooperate, Make Up the Answer You Want
From the abstract of “Insurance Status and Vaccination Coverage Among US Preschool Children,” in which the authors conclude that having coverage is an important “marker for underimmunization,” even though their multivariate findings show that it isn’t:
Results: “…Children with private insurance were more likely to be UTD (80%) [up to date with immunizations] than those with public insurance (56%) or no insurance (64%). In a multivariate analysis that controlled for child’s race/ethnicity, household income; maternal age/marital status/educational level; location of usual care; and Special Supplemental Nutrition Program for Women, Infants, and Children participation, insurance was no longer an independent predictor of vaccination.”
Conclusions: “The disparity in vaccination coverage among publicly, privately, and uninsured children is dramatic, underscoring its importance as a marker for underimmunization, despite the multivariate findings. The Vaccines for Children Program, a partnership between public health and vaccination providers who serve uninsured children and those enrolled in Medicaid, is well suited to target and improve vaccination coverage among these vulnerable children.”
The regression results suggested that receiving usual well-child care at a hospital clinic and having less than a high school education are associated with underimmunization. At the end of the paper, the authors write that “lower vaccination coverage among publicly insured children suggests that first-dollar-coverage laws may be an insufficient strategy among certain groups of vulnerable children.”
Linda, you don’t suffer fools gladly.
Good hatchet job.
I like the heading.
Most studies in health care are poorly designed and poorly executed.
Linda, did the study itself come to the same conclusion that was in the abstract? Often the abstracts are written by the editors of the publication, and are opposite of what the study itself says. Of course, the editors are never identified. Too bad we don’t have the time or resources to contact the researchers and ask them if they are comfortable with misleading abstracts being attached to their work.
Greg, yes the abstract does more or less represent what the paper said. Mainstream health policy seems unable to come to grips with the fact that people are different and that just giving everyone the same coverage will not produce identical individual health results. The full paper is available at the link.
I agree about the increasing prevalence of misleading abstracts slapped on health policy papers. I think it is a deplorable development.
This is another in a line of articles that actually concludes that Medicaid is more like being “uninsured” than “insured” (see, e.g. http://tinyurl.com/74pr58x).
So, “free” Medicaid immunizations are not taken up by the target audience to a satisfactory degree. The authors proposal is yet another “free” program, the VFC, which is run by the Centers for Disease Control.
What’s he difference, really? The VFC has been operating since 1994. How long are the authors going to wait before concluding that it is not boosting immunizations to the desired level?