This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Study From Pediatric Research in Office Settings (PROS)

Paul M. Darden, MD; James A. Taylor, MD; Eric J. Slora, PhD; Cynthia M. Hasemeier; Linda Asmussen; Julie C. Recknor, PhD; Richard C. Wasserman, MD

Arch Pediatr Adolesc Med. 1996;150(10):1027-1031.

Abstract
Objective
To compare 3 methods for measuring pediatric office immunization rates.

Design
Retrospective and prospective cross-sectional surveys.

Patients
Children 2 and 3 years old from 15 pediatric practices in 11 states.

Methods
Immunization rates were determined for each practice using 3 methods. The Consecutive method used data from the practice's medical records of patients seen consecutively in the office; the Chart method used data from randomly selected practice medical records; and the Active method (reference standard) used a combination of medical record data with a telephone interview to collect additional immunization data and current patient status, using data only on current patients. Analyses were based on a mean of 57, 62, and 51 (Consecutive, Chart, and Active method, respectively) patients per practice. Patients were considered fully immunized if they had received 4 doses of DTP/DT vaccine, 3 doses of OPV/IPV, and 1 dose of MMR vaccine by their second birthday. Comparisons were made using the paired t test.

Results
The mean immunization rate by method was Consecutive, 81.5% (range, 51%-97%); Chart, 71.6% (range, 42%-94%); and Active, 79.6% (range, 53%-96%). Within a given practice, the differences between methods varied considerably (0 to 28 percentage points). The mean difference from the reference standard Active method was 8 percentage points (P<.001) for the Chart method and –1.9 percentage points (P=.36) for the Consecutive method. The largest difference was between the Consecutive and Chart methods (mean difference, 9.9 percentage points; P=.003). Practitioners uniformly found the Consecutive method easiest to implement.

Conclusions
Practice-specific immunization rates are one of the few objective measures of the quality of preventive pediatric care. Pediatric practices monitoring their immunization rates should consider using the Consecutive method, a simple, acceptable, and valid measure of practice immunization rate.

Arch Pediatr Adolesc Med. 1996;150:1027-1031

Author Affiliations
From the Department of Pediatrics, Medical University of South Carolina, Charleston (Drs Darden and Recknor); Department of Pediatrics, University of Washington School of Medicine, Seattle (Dr Taylor); Pediatric Research in Office Settings (PROS), American Academy of Pediatrics, Elk Grove Village, Ill (Drs Slora and Wasserman and Mss Hasemeier and Asmussen); and Department of Pediatrics, University of Vermont College of Medicine, Burlington (Dr Wasserman).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

How Should Immunization Rates Be Measured in the Office Setting? A Study from PROS and NMA PedsNet
Darden et al.
CLIN PEDIATR 2008;47:252-260.
ABSTRACT  

CLINICAL ASSESSMENT SOFTWARE APPLICATION (CASA) AND IMMUNIZATION COVERAGE RATES
Stevenson et al.
AJPH 2002;92:333-333.
FULL TEXT  

The Effect of Different Definitions of a Patient on Immunization Assessment
O'Connor et al.
AJPH 2001;91:1273-1275.
ABSTRACT | FULL TEXT  

A Statewide Assessment of Lead Screening Histories of Preschool Children Enrolled in a Medicaid Managed Care Program
Vivier et al.
Pediatrics 2001;108 :e29-e29.
ABSTRACT | FULL TEXT  

Impact of Appointment Reminders on Vaccination Coverage at an Urban Clinic
Irigoyen et al.
Pediatrics 2000;106:919-923.
ABSTRACT | FULL TEXT  

Assessing Immunization Rates: The Importance of Denominators
Darden
Pediatrics 2000;106:169-170.
FULL TEXT  

Effect of Method of Defining the Active Patient Population on Measured Immunization Rates in Predominantly Medicaid and Non-Medicaid Practices
Morrow et al.
Pediatrics 2000;106:171-176.
ABSTRACT | FULL TEXT  

Immunization Levels and Risk Factors for Low Immunization Coverage Among Private Practices
Kahane et al.
Pediatrics 2000;105:73e-73.
ABSTRACT | FULL TEXT  

Improving Immunization Rates in Private Pediatric Practices Through Physician Leadership
Sinn et al.
Arch Pediatr Adolesc Med 1999;153:597-603.
ABSTRACT | FULL TEXT  

Assessing Immunization Performance of Private Practitioners in Maine: Impact of the Assessment, Feedback, Incentives, and Exchange Strategy
Massoudi et al.
Pediatrics 1999;103:1218-1223.
ABSTRACT | FULL TEXT  

Immunization Performance Measurement in a Changing Immunization Environment
Rodewald et al.
Pediatrics 1999;103:889-897.
ABSTRACT | FULL TEXT  

Pediatric Research in Office Settings (PROS): A National Practice-Based Research Network to Improve Children's Health Care
Wasserman et al.
Pediatrics 1998;102:1350-1357.
ABSTRACT | FULL TEXT  

Lessons From Practice-based Clinical Research
Genel
Pediatrics 1997;99:597-598.
FULL TEXT