UBC Theses and Dissertations
A survey of the immunization delivery system to preschool children in an urban Canadian community Everett, Wayne Alexander
A study was carried out of the mixed public—private delivery system for preschool immunizations in the Simon Fraser Health Unit, an urban health unit area in the Lower Mainland of British Columbia. The objectives of the study were to compare the effectiveness of physicians and public health nurses as providers of immunizations by specific measures of performance and to assess some of the determinants of parental preference for providers. General data was gathered from a literature review on these issues of provider effectiveness and parental preferences. Specific data was gathered on these two providers' effectiveness in timing measles immunization and parental willingness to pay user fees using a sample survey of 600 randomly selected three year old children born in 1978 in the health unit area. The literature reviewed and the results of the survey suggested that public health nurses provide equivalent or better services by specific measures of performance. In particular, the survey was able to show that public health nurses more closely adhered to provincial policies for the timing of measles immunizations. The survey also showed a mix of 55% private and 45% public delivery in the area studied. Prominent determinants of parental preference for both providers were found to be convenience (38%), personal preferences other than convenience (34%), and physician's advice (25%). Respondents in the survey were split on their willingness to pay user fees for these preventive care services. Finally based upon the findings of this study, a number of future studies were suggested. In particular, cost-minimization studies were recommended to assess the potential of various supply and demand side controls in making the current mixed delivery system of preschool immunization more efficient.
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