Availability of Vaccines for Children Providers in Texas: A County-Level Analysis

Abstract

s / Annals of Epidemiology 23 (2013) 581e598 590 Results: GEE and REmodels revealedmodest protective effects of training on in-hospital mortality for colectomy (OR1⁄40.79, 95% CI 1⁄4 0.611.02), but not gastrectomy (OR1⁄40.88, 95% CI 1⁄4 0.63-1.22). However, protective effects were more pronounced for high-volume surgeons in highvolume hospitals (vs. low surgeon/hospital volume) (colectomy: OR1⁄40.55, 95% CI 1⁄4 0.47-0.65; gastrectomy: OR1⁄40.46, 95% CI 1⁄4 0.34-.61). Conclusion: Training appears to be less important than surgeon and hospital volume. These findings may have implications for surgical training programs and for regionalization of complex surgical procedures. P39. Availability of Vaccines for Children Providers in Texas: A County-Level Analysis J.M. Eberth, J. Hibbert. University of South Carolina, Columbia, SC Purpose: The Vaccines for Children (VFC) program provides vaccines recommended through the Advisory Committee on Immunization Practices free of charge to children who are aged 0-18 and Medicaid-eligible, un/underinsured, or AI/AN. Ensuring equitable access to these services is a public health priority. The purpose of our study was to examine the availability of VFC providers in Texas from a spatial perspective. Methods: We obtained data on the locations of all VFC-registered providers in Texas from the TX Department of State Health Services Immunization Branch and the San Antonio Metropolitan Health District in April 2011. Using ArcGIS V10.1, wemapped the locations of all the VFCregistered providers and summarized the results at the county-level. Results: Eighteen counties, mostly in the West or Northwestern part of the state, did not have a registered VFC provider. Several of these counties were spatially contiguous, representing a substantial shortage of the vaccine safety-net for portions of Texas. The range of VFC providers per county was 0549 (Mean 1⁄4 15, Median 1⁄4 5). Conclusion: Our preliminary work indicates several pockets of low availability of VFC providers in West and Northwestern Texas, but adequate availability on the whole. Future work will address the spatial accessibility of these VFC providers, accounting for both the supply and potential demand