Article | Medical Care | June 2016

Vaccination Rates Are Associated with Functional Proximity but Not Base Proximity of Vaccination Clinics

by John Beshears, James J. Choi, David Laibson, Brigitte C. Madrian and Gwendolyn I. Reynolds

Abstract

Background: Routine annual influenza vaccinations are recommended for persons 6 months of age and older, but less than half of U.S. adults get vaccinated. Many employers offer employees free influenza vaccinations at workplace clinics, but even then take-up is low.

Objective: To determine whether employees are significantly more likely to get vaccinated if they have a higher probability of walking by the clinic for reasons other than vaccination.

Method: We obtained data from an employer with a free workplace influenza vaccination clinic. Using each employee’s building entry/exit swipe card data, we test whether functional proximity—the likelihood that the employee walks by the clinic for reasons other than vaccination—predicts whether the employee gets vaccinated at the clinic. We also test whether base proximity—the inverse of walking distance from the employee’s desk to the clinic—predicts vaccination probability.

Participants: A total of 1,801 employees of a health benefits administrator that held a free workplace influenza vaccination clinic.

Results: A 2 SD increase in functional proximity is associated with a 6.4 percentage point increase in the probability of vaccination (total vaccination rate at company=40%), even though the average employee’s desk is only 166 meters from the clinic. Base proximity does not predict vaccination probability.

Conclusions and Relevance: Minor changes in the environment can have substantial effects on the probability of vaccination. If these results generalize, health systems should emphasize functional proximity over base proximity when locating preventive health services.

Keywords: Geographic Location; Employees; Health Care and Treatment;

Citation:

Beshears, John, James J. Choi, David Laibson, Brigitte C. Madrian, and Gwendolyn I. Reynolds. "Vaccination Rates Are Associated with Functional Proximity but Not Base Proximity of Vaccination Clinics." Medical Care 54, no. 6 (June 2016): 578–583.