The development of performance and cost indicators for preschool immunisation

Area of Science:

• Pediatrics
• Public Health
• Health Services Research

Background:

• Child health clinics vary in organization, premises, and staffing.
• Inner-city clinics present unique challenges for service delivery and patient outreach.
• Computerized child registers offer valuable data for service evaluation.

Purpose of the Study:

• To compare the organization, staffing, and cost of three different types of inner-city child health clinics.
• To analyze how clinic-specific factors influence childhood immunization uptake, consent rates, and compliance.
• To identify potential areas for improving immunization program efficiency and cost-effectiveness.

Main Methods:

• Comparative analysis of three distinct inner-city child health clinics.
• Utilized data from computerized child registers and other returns for immunization information.
• Included simple cost estimations and analysis of clinic clientele characteristics, staffing, and facilities.

Main Results:

• Significant differences observed in overall antigen uptake, consent rates, and post-consent compliance among clinics.
• Pertussis immunization consent varied widely (90% vs. 69%).
• Median age for the third dose of triple vaccine ranged from 314 to 375 days, with variations in compliance and clinic factors.

Conclusions:

• Clinic organization, staffing, clientele characteristics, and facilities significantly impact immunization uptake and cost.
• Systematic use of clinic-level indicators from child health computer systems can identify improvement opportunities.
• Data-driven insights are crucial for enhancing vaccine uptake and optimizing cost-effectiveness in child health services.