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1.  The Impact of Gaps in Health Insurance Coverage on Immunization Status for Young Children 
Health Services Research  2008;43(5 Pt 1):1619-1636.
To examine the impact of full-year versus intermittent public and private health insurance coverage on the immunization status of children aged 19–35 months.
Data Source
2001 State and Local Area Integrated Telephone Survey's National Survey of Children with Special Health Care Needs (NS-CSHCN) and the 2000–2002 National Immunization Survey (NIS).
Study Design
Linked health insurance data from 2001 NS-CSHCN with verified immunization status from the 2000–2002 NIS for a nationally representative sample of 8,861 nonspecial health care needs children. Estimated adjusted rates of up-to-date (UTD) immunization status using multivariate logistic regressions for seven recommended immunizations and three series.
Principal Findings
Children with public full-year coverage were significantly more likely to be UTD for two series of recommended vaccines, (4:3:1:3) and (4:3:1:3:3), compared with children with private full-year coverage. For three out of 10 immunizations and series tested, children with private part-year coverage were significantly less likely to be UTD than children with private full-year coverage.
Our findings raise concerns about access to needed immunizations for children with gaps in private health insurance coverage and challenge the prevailing belief that private health insurance represents the gold standard with regard to UTD status for young children.
PMCID: PMC2653891  PMID: 18522671
Immunization; vaccine; health care access
2.  Willingness to pay for prevention and treatment of lymphatic filariasis in Leogane, Haiti 
Filaria Journal  2004;3:2.
Lymphatic filariasis (LF) affects more than 120 million people worldwide. Efforts to eliminate this disease require sustained community participation. This study explores community valuation of LF elimination efforts by estimating household and community willingness to pay (WTP) for the prevention of transmission and treatment of filarial lymphedema in the community of Leogane, Haiti.
A contingent valuation survey was used to assess individual WTP for specific prevention and treatment interventions. A 2-dimensional Monte Carlo simulation was developed to estimate confidence limits in mean WTP and to generate a distribution of WTP for the community, accounting for uncertainty in regression coefficients and variability within the population.
Mean WTP was estimated to be $5.57/month/household (95% CL: $4.76, $6.72) to prevent disease transmission, and $491/yr (95% CL: $377, $662) for treatment of lymphedema for one person. Based on the estimated distributions, 7% and 39% of households were not willing to pay for prevention and treatment, respectively.
These results suggest that the majority of the community places a positive value on both prevention and treatment of LF. Mean WTP provides a useful monetary estimate of overall societal benefit of LF prevention and treatment programs. However, for interventions which require broad and sustained community participation, the lower end of the distribution of WTP has additional implications. Cost recovery policies may result in inadequate participation and longer program duration.
PMCID: PMC356926  PMID: 14754463
Lymphatic filariasis; willingness to pay; cost; contingent valuation

Results 1-2 (2)