KEYWORDS:
Practice coverage rates; immunization registry
BACKGROUND:
Chart audits are the gold standard for assessing practice coverage but are time and labor intensive. Immunization registries offer the potential for reliable and timely assessments.
OBJECTIVE(S):
To simulate practice immunization chart audits using an immunization registry.
METHOD(S):
Two years after registry rollout, we conducted registry-based immunization coverage assessments for October 2001 and April 2002 at 5 practices serving a low-income, minority community in New York City. Children were eligible for inclusion if they had at least one visit to the practice. We compared two assessment methods: universal (100%) (n=16073) vs. random sample using standard CASA audit sample procedures (n=3438). The outcome assessed was age-appropriate immunization rates for DTaP, Polio, MMR, Hib, and HepB (4:3:1:3:3) for 6-35 month olds.
RESULT(S):
82% of the cases had at least one immunization recorded in the registry. The coverage rate difference between universal and CASA sampling ranged from 0.6% to 2.7% for Oct 2001 and from 1.4% to 2.9% for Apr 2002. The difference in coverage rate was smallest for children 6-11 months of age.
CONCLUSIONS(S):
When using immunization registries for practice coverage assessments, random sampling using CASA methodologies yields comparable results to universal sampling.
LEARNING OBJECTIVES:
Sample methodology for registry-based assessments
Handout (.ppt format, 131.0 kb)
Handout (.ppt format, 113.0 kb)
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