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Immunization compliance outside the health plans. A non-HMO report card
Insights
This study found high immunization rates in a private practice, with 72% of children completing the DTP, OPV, and MMR series by age two. However, missed opportunities for vaccination were also frequent, indicating areas for practice improvement.
Area of Science:
- Pediatric healthcare
- Public health
- Immunization practices
Background:
- Childhood immunizations are critical for disease prevention.
- Assessing immunization rates in private medical practices is important for public health.
- Previous studies have focused on Health Maintenance Organizations (HMOs).
Purpose of the Study:
- To evaluate the completion rates of childhood immunizations by 24 months of age.
- To identify the percentage of children receiving specific vaccines (DTP, OPV, MMR).
- To analyze missed opportunities for immunization in a private practice setting.
Main Methods:
- A retrospective chart review was conducted.
- The study included children born between January 1, 1990, and June 30, 1992.
- Children seen at the private practice between 15 and 24 months of age were analyzed.
Main Results:
- 77% of children received four DTP, 78% received three OPV, and 82% received one MMR vaccine by 24 months.
- 72% achieved the recommended combination of DTP, OPV, and MMR immunizations.
- Children with serious medical conditions did not show significantly different immunization rates.
- Missed opportunities for vaccination were higher in children who did not complete the series.
Conclusions:
- Immunization rates in this private practice are high and comparable to those in HMOs.
- A significant rate of missed opportunities for vaccination was observed.
- The findings will guide improvements in immunization strategies within the medical group.
Purpose:
To assess the rate of completed immunizations by age 24 months in children cared for by a private medical practice.
Methods:
A chart review of all children born between January 1, 1990, and June 30, 1992, and seen by a provider in this private medical practice at least once between ages 15 months and 24 months.
Results:
Overall, 77% of children received four DTP immunizations, 78% received at least three OPV immunizations, and 82% at least one MMR by 24 months of age. Seventy-two percent received the recommended combination of one MMR, three OPV, and four DTP immunizations by age 2. Rates were about 5% to 10% higher in children delivered by physicians of the group practice where the study occurred. The presence of a serious medical problem did not statistically significantly change the rates of completed immunizations. The rate of missed opportunities was almost three times as high in those not completing the basic DTP, OPV, MMR immunization series by age 24 months.
Conclusions:
Rates of immunizations are high in this private group practice and comparable to those reported by HMOs that care exclusively for children with insurance. However, the rate of missed opportunities is also high, with three to four visits for each child who did not complete the basic immunization series by age 24 months. This private practice report card will be used to improve immunization practices in our medical group.