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Provider chart audits and outreach to parents: impact in improving childhood immunization coverage and immunization
Maureen S Kolasa1, James P Lutz, Abbey Cofsky
1Health Services Research and Evaluation Branch, National Center for Immunization and Respiratory Disease, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. mkolasa@cdc.gov
Insights
Provider chart audits improved data accuracy, while parental outreach helped some children catch up on immunizations. Continued outreach and new strategies are needed to ensure children remain up-to-date on vaccinations.
Area of Science:
- Public Health
- Preventive Medicine
- Health Informatics
Background:
- Childhood immunization coverage is crucial for public health.
- Gaps in immunization coverage persist, particularly in at-risk populations.
- Accurate immunization information systems (IIS) are vital for monitoring and improving vaccination rates.
Purpose of the Study:
- To assess the effectiveness of provider chart audits and parental outreach in increasing immunization coverage.
- To evaluate strategies for children not up-to-date (NUTD) with immunizations in Philadelphia's IIS.
- To improve data completeness and timeliness in the IIS.
Main Methods:
- Identified 10-month-old children NUTD using Philadelphia's IIS.
- Compared immunization rates at 10, 13, and 19 months before and after interventions.
- Interventions included provider chart audits and parental outreach (telephone, postcards, home visits).
Main Results:
- Provider chart audits revealed many children initially flagged as NUTD were actually up-to-date (UTD).
- Parental outreach led to overdue immunizations for half of truly NUTD children by 13 months.
- However, only 23% of these children remained UTD at 19 months.
Conclusions:
- Provider chart audits enhance IIS data accuracy, highlighting the need for timely provider data submission.
- Parental outreach is effective in the short-term but requires sustained efforts through 19 months.
- New strategies are essential to ensure sustained immunization coverage for all children.
Objective:
Examine impact of provider chart audits and parental outreach in improving immunization coverage among children not up-to-date (NUTD) for immunizations in Philadelphia's immunization information system (IIS).
Methods:
We identified 10-month-old children NUTD for age-appropriate immunizations using Philadelphia's IIS. Immunization rates at 10, 13, and 19 months were compared before and after contact with providers and parents.
Results:
Of 5 610 children NUTD in the IIS at 10 months and living in areas with populations at risk for underimmunization, provider chart audits indicated that 3 612 (64%) were actually up-to-date (UTD); the majority of these (2 203) received additional age-appropriate immunizations and were also UTD at 19 months. Of 1 998 children truly NUTD at 10 months, half received overdue immunizations by 13 months following contact with parents via telephone, postcards, and home visits, but only 23 percent were UTD for age-appropriate vaccines at 19 months.
Conclusions:
Provider chart audits improved IIS data completeness, indicating that providers need to submit more complete and timely data to the IIS. Outreach to parents likely contributed to half of the children NUTD at 10 months receiving overdue immunizations by 13 months. However, most were again NUTD at 19 months, indicating that outreach efforts should be continued through 19 months or until children are brought UTD. Furthermore, in spite of outreach, about half of the NUTD children were not brought UTD by 13 or 19 months. New strategies should be developed to ensure that these children receive recommended vaccinations.
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