{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T19:14:50Z","timestamp":1790277290421,"version":"4.1.0"},"reference-count":21,"publisher":"American Public Health Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[1999,2]]},"abstract":"<jats:p> OBJECTIVES: The purpose of this study was to examine the effects on immunization coverage of 3 incentives for physicians--a cash bonus for practice--wide increases, enhanced fee for service, and feedback. METHODS: Incentives were applied at 4-month intervals over 1 year among 60 inner-city office-based pediatricians. At each interval, charts of 50 randomly selected children between 3 and 35 months of age were reviewed per physician. RESULTS: The percentage of children who were up to date for diphtheria, tetanus, and pertussis and Haemophilus influenzae type b; polio; and measles-mumps-rubella immunization in the study's bonus group improved by 25.3 percentage points (P &lt; .01). No significant changes occurred in the other groups. However, percentage of immunizations received outside the participating practice also increased significantly in the bonus group (P &lt; .01). Levels of missed opportunities to immunize were high in all groups and did not change over time. Physicians' knowledge of contraindications was low. CONCLUSIONS: Bonuses sharply and rapidly increased immunization cover-age in medical records. However, much of the increase was the result of better documentation. A bonus is a powerful incentive, but more structure or education may be necessary to achieve the desired results. <\/jats:p>","DOI":"10.2105\/ajph.89.2.171","type":"journal-article","created":{"date-parts":[[2008,11,29]],"date-time":"2008-11-29T13:33:29Z","timestamp":1227965609000},"page":"171-175","source":"Crossref","is-referenced-by-count":176,"title":["The impact of physician bonuses, enhanced fees, and feedback on childhood immunization coverage rates."],"prefix":"10.2105","volume":"89","author":[{"given":"G","family":"Fairbrother","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K L","family":"Hanson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Friedman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G C","family":"Butts","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"844","reference":[{"key":"p_1","unstructured":"Financial indicators: trade, exchange rates, and reserves. 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New York, NY: United Hospital Fund; 1994."},{"key":"p_15","unstructured":"Guidelines for Assessing Vaccination Levels of the 2-Year-Old Population in a Clinic Setting. Atlanta, Ga: Centers for Disease Control; October 1992."},{"key":"p_16","unstructured":"Lee ES, Forthofer RN, Lorimor RJ. Analyzing Complex Survey Data. Newbury Park, Calif: Sage Publications; 1989."},{"key":"p_17","unstructured":"Shah BV, Bamwell BG, Hunt N, LaVange L. SUDAAN User's Manual: Professional Software for Survey Data Analysis for Multi-Stage Sample Designs. Research Triangle Park, NC: Research Triangle Institute; 1992."},{"key":"p_18","first-page":"1","volume":"42","author":"National Vaccine Advisory Committee","year":"1993","journal-title":"MMWR Morb Mortal Wkly Rep."},{"key":"p_19","unstructured":"Lofgren JP, Brown HR, Lesinger C, Sims W. Increase in Alabama public health immunization levels coinciding with monthly distribution of county immunization levels comparisons and financial rewards for accomplishments. In: Conference abstracts from the 31st National Immunization Conference; May 19-22, 1997; Detroit, Mich. Abstract 046."},{"key":"p_20","unstructured":"Hause J, Silva N, Lazorik D. The use of AFIX as a motivational tool in the Massachusetts WIC program. In: Conference abstracts from the 31st National Immunization Conference; May 19-22, 1997; Detroit, Mich. Abstract 044."},{"key":"p_21","unstructured":"Walsh J, Bogdan G, Jankoski A, etal. Using AFIX to increase immunization levels in private physicians' offices in Maine. In: Conference abstracts from the 31st National Immunization Conference: May 19-22, 1997; Detroit, Mich. Abstract 053."}],"container-title":["American Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ajph.aphapublications.org\/doi\/pdf\/10.2105\/AJPH.89.2.171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T20:20:52Z","timestamp":1652127652000},"score":1,"resource":{"primary":{"URL":"https:\/\/ajph.aphapublications.org\/doi\/full\/10.2105\/AJPH.89.2.171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,2]]},"references-count":21,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1999,2]]}},"alternative-id":["10.2105\/AJPH.89.2.171"],"URL":"https:\/\/doi.org\/10.2105\/ajph.89.2.171","relation":{},"ISSN":["0090-0036","1541-0048"],"issn-type":[{"value":"0090-0036","type":"print"},{"value":"1541-0048","type":"electronic"}],"subject":[],"published":{"date-parts":[[1999,2]]}}}