KEYWORDS:
Continuity of Care, Well-Child Visit, Immunizations

BACKGROUND:
The goal of the Child Health Network Immunization Project (CHNIP) was to improve immunization rates of children ages 0-35 months within the context of primary care. To assist continuity of care, ‘continuity coordinators’ (CC) were placed in three urban primary care clinics, a community-based clinic and two hospital-based clinics.

OBJECTIVE(S):
To assess the impact of a clinic-based intervention on continuity of care and immunization coverage in children 0-18 months.

METHOD(S):
CCs provided clients with reminder/recall and met clients during visits to review immunization status and schedules. A comparison group was drawn from at the same clinic included in a CASA assessment who did not receive any contact from the clinic’s CC. The CCs maintained a database of client contacts, well child visits scheduled and kept, as well as immunizations provided. The percent age-appropriate up-to-date according to the ACIP schedule (UTD) was calculated at 3 month intervals from birth.

RESULT(S):
The community-based clinic received significant benefit from the CC position. For this clinic’s children who attained the age of 12 months (n=101), the UTD was 79% verse 57% for those not receiving assistance from the CC (n=61). The hospital-based clinics had higher baseline immunization coverage at each age interval and no significant advantage to CC clients were found.

CONCLUSIONS(S):
The intervention of a ‘continuity coordinator’ produced a significant positive effect in immunization coverage for children 0-12 months of age in a community-based clinic. This salutary effect may be due to the need of the clinic’s families to receive assistance and the efforts on the part of the clinic to fully integrate the CC into their patient scheduling, education, and outreach.

LEARNING OBJECTIVES:
Understand the scope of effort required to implement a strategy intended to ensure continuity of care and the setting in which this strategy may be most efficacious.