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Comparison of immunisation rates in general practice and child health clinics
1Department of Community Child Health, Royal Free Hospital School of Medicine, London.
Insights
General practices showed higher immunisation uptake rates compared to community child health clinics. This suggests that supporting general practitioners, particularly in urban areas, could improve childhood immunisation coverage.
Area of Science:
- Public Health
- Pediatrics
- Health Services Research
Background:
- Childhood immunisation is crucial for preventing infectious diseases.
- Understanding variations in immunisation uptake is essential for optimising public health strategies.
Purpose of the Study:
- To compare immunisation uptake rates between general practice surgeries and community child health clinics.
- To identify factors influencing immunisation scheduling and completion.
Main Methods:
- A cohort study was conducted using data from a computerised child health system.
- The study included 3616 children born between January and March 1990 across four health districts.
- Immunisation uptake, age at immunisation, and scheduling performance were assessed.
Main Results:
- General practices achieved an 80% completion rate for the third pertussis dose, versus 68% in child health clinics.
- Median age for the third dose was earlier in general practices (24 weeks) than in clinics (29 weeks).
- Children in rural/suburban areas had higher uptake than those in inner cities; clinic-registered children had 1.4x higher odds of incomplete immunisation.
Conclusions:
- General practices demonstrated superior immunisation uptake rates compared to child health clinics.
- Enhanced support for general practitioners, especially in inner-city areas, may improve overall immunisation coverage.
- Geographical location significantly impacts immunisation rates, with inner-city areas lagging behind rural and suburban districts.
Objective:
To compare immunisation uptake rates in general practice surgeries and community child health clinics.
Design:
Cohort study using data from a computerised child health system.
Setting:
Four health districts of North East Thames Regional Health Authority.
Subjects:
3616 children born January to March 1990 and resident in the four districts at the end of January 1991.
Main Outcome Measures:
Immunisation uptake rates at 10-12 months of age, age at immunisation, scheduling performance at the two locations, and odds ratios of outstanding immunisations.
Results:
80% of children registered at general practices had completed their third dose of pertussis immunisation compared with 68% of those at health clinics. Median ages at the third dose were 24 weeks and 29 weeks at the two locations respectively. Scheduling was more effective at general practice surgeries. Unscheduled immunisations were more likely to be given after the recommended age. Overall, children resident in rural and suburban areas had greater uptakes than those in inner cities. Odds ratios for not being fully immunised among children registered at health clinics were 1.4 times those among children immunised in general practice and 3.0 times greater among children resident in inner cities than among those in rural and suburban districts. Children who moved into a district, however, were no less likely to be fully immunised than children who were born there.
Conclusions:
The immunisation uptake rate was better in general practices than in child health clinics in both inner city and rural and suburban areas. Uptake may be increased with additional support to enable general practitioners to undertake immunisations, especially in inner cities.