title: Human papillomavirus vaccination recommendation may be linked to reimbursement: a survey of Virginia family practitioners and gynecologists.
abstract: OBJECTIVE
  Concerns have been raised about gynecologists as vaccinators. This survey evaluated use of the human papillomavirus (HPV) vaccine, attitudes, and barriers among gynecologists and family practitioners for differences between the 2 specialties.
  
  
  METHODS
  A cross-sectional survey was conducted using a 50-item, self-administered questionnaire mailed to participants.
  
  
  METHODS
  The study was conducted in Virginia through the University of Virginia Center for Survey Research.
  
  
  METHODS
  The questionnaire was mailed to 500 family practitioners and 500 gynecologists.
  
  
  METHODS
  The questionnaire asked provider and practice demographics, vaccine practices, knowledge, HPV vaccine attitudes, and barriers to vaccination.
  
  
  METHODS
  We compared gynecologists to family practitioners for the outcome of offering HPV vaccination. Logistic regression was performed to determine factors associated with providers choosing to offer and recommend the HPV vaccine.
  
  
  RESULTS
  After exclusion of ineligible physicians, 385 of 790 doctors responded (48.7%). Seventy percent of family practitioners and 73.5% of gynecologists currently offer the HPV vaccine. There were no significant differences in demographics or practice patterns between the specialties. The most frequent barrier to vaccination reported by both groups was reimbursement. In multivariate logistic regression, inadequate reimbursement was negatively associated with offering the HPV vaccine (odds ratio [OR] 0.41; 95% confidence interval [CI] 0.15-1.1) and with recommending the vaccine to patients (OR 0.45; 95% CI 0.26-0.76). Experience treating HPV- related disease was positively associated with offering the HPV vaccine (OR 2.3; 95% CI 1.1-4.8).
  
  
  CONCLUSIONS
  Gynecologists are providing HPV vaccination at rates similar to family practitioners. Reimbursement concerns may negatively have an impact on doctors' recommendation of the HPV vaccine.
authors: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA. youngjl@musc.edu
authors: Jennifer L
authors: JL
authors: Young
authors: Ruth G
authors: RG
authors: Bernheim
authors: Jeffrey E
authors: JE
authors: Korte
authors: Mark H
authors: MH
authors: Stoler
authors: Thomas M
authors: TM
authors: Guterbock
authors: Laurel W
authors: LW
authors: Rice
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D037001:Directive Counseling; D005194:Family Practice / Q000706:statistics & numerical data*; D006176:Gynecology / Q000706:statistics & numerical data*; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000191:economics*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D030361:Papillomavirus Infections / Q000188:drug therapy / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000191:economics* / Q000627:therapeutic use; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D014611:Vaccination / Q000191:economics*; D014768:Virginia
chemical_list: D053918:Papillomavirus Vaccines