The effect of different definitions of a patient on immunization assessment

Area of Science:

• Pediatrics
• Public Health
• Health Informatics

Background:

• Accurate immunization assessment is crucial for public health surveillance and disease prevention.
• The definition of a
• patient
• within health assessment software can influence reported vaccination coverage rates.
• Previous studies have not fully explored how different patient definitions impact immunization data accuracy.

Purpose of the Study:

• To compare the accuracy of immunization assessment using two distinct patient definitions within the Clinical Assessment Software Application (CASA).
• To identify potential underestimation of immunization rates due to specific software patient criteria.

Main Methods:

• Two distinct samples of 200 two-year-old children were assessed using CASA.
• Sample 1 included children with at least one visit since birth; Sample 2 included children seen in the previous year.
• Children with incomplete immunizations in Sample 1 were contacted for follow-up data.

Main Results:

• The second sample (recent visits) showed a 72% complete immunization rate, significantly higher than the 46% in the first sample (any visit since birth).
• In the first sample, 78% of incompletely immunized children had not had a visit in the past year.
• Among contacted children from the first sample (seen in the past year or reached), 75% had complete immunizations.

Conclusions:

• The patient definition employed in the CASA assessment underestimates actual childhood immunization rates.
• Utilizing a more restrictive patient definition, such as recent healthcare encounters, yields a more accurate representation of immunization coverage.
• Recommendations for improving immunization surveillance systems based on patient definition are implied.