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Measuring pediatric immunization status in a managed care organization: agreement between medical charts and parent
C A McPhillips-Tangum1, R Aubert, C M Bailey
1Prudential Center for Health Care Research, Atlanta, GA 30339, USA. cmphillips-tangum@prudential.com
Insights
Pediatric immunization record accuracy varies. Medical chart reviews are more reliable than parent interviews, especially for multiple-dose vaccines, but chart omissions exist. Parents referencing shot records provide accurate data.
Area of Science:
- Pediatric healthcare
- Public health
- Health services research
Background:
- Accurate tracking of pediatric immunizations is crucial for disease prevention.
- Discrepancies between medical records and parental recall can impact public health initiatives.
Purpose of the Study:
- To compare the accuracy of pediatric immunization data from medical charts versus parent telephone interviews.
- To evaluate the reliability of immunization information obtained from parents.
Main Methods:
- A study involving 356 children and their parents within Prudential HealthCare.
- Data collection through medical chart reviews and parent telephone interviews.
- Assessing agreement on immunization status between the two data sources.
Main Results:
- Agreement between medical charts and parent interviews ranged from poor to good, improving when parents used shot records.
- Higher agreement was observed for single-dose vaccines (e.g., MMR) compared to multiple-dose vaccines (e.g., DTP).
- Medical charts had omissions, and parents referencing shot records provided reliable data (r = .8807-1.0).
Conclusions:
- Medical chart reviews are superior for assessing immunization series completion in managed care settings, particularly when parents lack shot records.
- Parental recall is less reliable for multiple-dose vaccines.
- Improving the completeness of medical immunization records is essential.
Objective:
To measure the agreement between pediatric immunization data obtained from medical charts and data provided by parents during telephone interviews and to assess the reliability of immunization information provided during parent telephone interviews.
Design:
Medical charts reviews and telephone interviews with parents.
Setting:
Prudential HealthCare.
Participants:
Children sampled for the 1993 HEDIS study and the parents of those children (n = 356).
Main Outcome Measure:
Overall agreement between immunization data obtained from medical charts and data provided by parents during telephone interviews.
Results:
Agreement between immunization data obtained from medical charts and data provided in parent telephone interviews varies from poor to good if the parent refers to a shot record during the interview. Agreement between the two data sources is better with single dose vaccines (i.e., 1 MMR) than multiple dose vaccines (i.e., 4 DTP). Although parents tend to report fewer immunizations than are indicated in the child's medical chart, the medical charts in this study contained too many vaccine omissions to be considered reliable "gold standards" of vaccine receipt. Parents who refer to a shot record when providing information about pediatric immunizations provide reliable data (r = .8807-1.0).
Conclusion:
When measuring completion of the immunization series, especially among parents who do not have access to a shot record, medical chart reviews remain the better approach in the managed care setting.