Managed care organizations' performance in delivery of childhood immunizations (HEDIS, 1999-2002)

To examine recent trends in childhood immunizations recommended by the Advisory Committee for Immunization Practices measured by the Health Plan Employer Data and Information Set (HEDIS) and to describe the factors associated with higher rates over time.

The HEDIS performance measures from 1999 to 2002 and plan characteristics include approximately 400 enrollees per plan each year.

Longitudinal regression analysis of commercial managed care organizations' HEDIS measures. The outcome measure was the proportion of children aged 24 to 35 months in the plan who received 4 doses of diphtheriatetanus-pertussis vaccine, 3 doses of polio vaccine, 1 dose of measles-mumps-rubella vaccine, 3 doses of Haemophilus influenzae type b vaccine, and 3 doses of hepatitis B vaccine.

The mean immunization rate for health insurance plans increased from 65.7% in 1999 to 67.9% to 2002. Plans that reported publicly had higher childhood immunization rates than plans that did not report publicly (P < .001). Plans with higher proportions of Hispanics or African Americans had lower childhood immunization rates (P < .001). Immunization rates varied significantly by type of visit; plans with higher proportions of children making visits to their primary care physician had higher rates of immunization (P < .001).

Managed care organizations' performance measured by childhood immunization rates varies by organizational and demographic factors. Our findings suggest that plans should ensure efficient and accurate data collection systems and should encourage their providers to assess for immunizations at sick-child and well-child care visits.