[The MMR vaccination: no effect of feedback of vaccination scores in general practice]

The purpose of this study was to assess the effect of graphic feed-back of vaccination scores (VS) for vaccination against measles, mumps and rubella (MMR) at the age of 15 months among practices in a Danish county. The study was designed as an intervention study, comparing VS for each practice with VS for the other practices in the county. The feed-back was evaluated qualitatively by use of a postal questionnaire. A majority of the 73 responding practices welcomed the graphic feed-back, regarded it as easily understood and requested similar information on an annual basis in the future. In 13 (18%) of the practices, the calculated VS was lower than the doctors had expected. The most frequent explanation for this discrepancy, given by 4 practices, was incorrect registration of the vaccination. Twenty-one percent of the practices had taken action to improve their performance after receiving the feed-back, but there was no significant improvement in VS in this group. In practices with low VS (< 70%) before intervention, there was no significant change in VS. The total VS for all practices in the county was 89% before and 88% after intervention. In conclusion, the feed-back had no observable effect on VS. Registration errors may explain why some practices had low VS. Feed-back with performance indicators may have better quantitative effect if accompanied by qualitative measures.