KEYWORDS:
Practice coverage rates; immunization registry
BACKGROUND:
Immunization registries are expected to include all immunizations on a real-time basis, but this may not be the case. Differences in immunization rates by point of service may highlight problems in registry completeness.
OBJECTIVE(S):
To compare registry-based coverage rates at the last point of service with those calculated on a real-time basis.
METHOD(S):
Using a two-year old network immunization registry, we conducted immunization assessments at 5 practices serving a low-income, minority community in New York City. All children 6-23 months of age with at least one visit to the practice were included in the assessment (n=4725). We compared coverage rates at two points in time: an arbitrary audit date (April 2002) vs. the last point of service prior to April 2002. The outcome assessed was age-appropriate immunization rates for DTaP, Polio, MMR, Hib, and HepB (4:3:1:3:3).
RESULT(S):
81% of children had at least one immunization record in the registry. Real-time coverage rates were 48.1% for 6-11 months old and 39.5% for 12-23 months old, while the last point of service coverage rates were 78.3% for 6-11 months old and 70.6% for 12-23 months old, a difference of 30% in coverage rate for both age groups.
CONCLUSIONS(S):
The difference in coverage rate by time of assessment suggests poor documentation, record scatter, or disengagement from care. Registry-based assessments on real-time and last point of service offers complementary perspectives on vaccine delivery and documentation that can guide registry quality improvement.
LEARNING OBJECTIVES:
Methodology for improving registry completeness
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