Influence of Office Systems on Pediatric Vaccination Rates

Clin Pediatr (Phila). 2017 Mar;56(3):231-237. doi: 10.1177/0009922816650396. Epub 2016 Jul 12.

Abstract

This study seeks to better understand the impact of practice-level factors on up-to-date (UTD) rates in children. We compared practice-level vaccination rates for 54 practices to survey data regarding office practices for staffing, vaccine delivery, reminder-recall, and quality improvement. Vaccination rates at 24 and 35 months were analyzed using t tests, analysis of variance, and linear regression. Private practices and those using standing orders had higher UTD rates at 24 months ( P = .01; P = .03), but not at 35 months. Having a pediatrician in the office was associated with higher UTD rates at both 24 and 35 months ( P < .01). Participating in a network and taking walk-in patients were associated with lower UTD rates ( P = .03; P = .03). As the percentage of publicly insured patients decreases, the UTD rate rises at 24 and 35 months ( r = -0.43, P = .001; r = -0.037, P = .007). Reported use of reminder recall-systems, night/evening hours, and taking walk-in patients were not associated with increased UTD rates.

Keywords: care delivery systems; childhood vaccines; office systems.

MeSH terms

  • Child, Preschool
  • Female
  • Humans
  • Immunization / statistics & numerical data*
  • Male
  • Pediatrics / organization & administration*
  • Pediatrics / statistics & numerical data*
  • Physicians' Offices / organization & administration*
  • Physicians' Offices / statistics & numerical data*
  • Quality Improvement / statistics & numerical data
  • Reminder Systems / statistics & numerical data