The 36th National Immunization Conference of CDC

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751

The Association Between Medical Home and Immunization Coverage Rates

Nathan E. Crawford1, Shannon Siegel1, Liagrong Wu1, and Kenneth Rosenberg2. (1) Immunizations, Oregon Dept of Human Services, 800 NE Oregon St, Portland, OR, USA, (2) Office of Family Health, Oregon Dept of Human Services, USA


KEYWORDS:
medical home; immunization

BACKGROUND:
Continuity of care and a medical home where a patient receives comprehensive care over a long time period is theorized to contribute to better health care. However, the literature associating a medical home with better health or improved immunization rates is sparse and, in some cases, contradictory.

OBJECTIVE(S):
The purpose of this study was to calculate an odds ratio for a reported “medical home,” quantifying the degree to which a medical home was likely to be found among those children up-to-date by 24 months of age.

METHOD(S):
Using stratified random sampling from birth certificates, we conducted a retrospective cohort study of risk factors for Oregon children not having 4 diphtheria-tetanus-pertussis vaccines, 3 polio vaccines and 1 measles-containing vaccine (4:3:1) by the time they were 24 months old.

RESULT(S):
Among 1633 children studied, going to the same clinic or doctor for primary care and immunizations most of the time ("having a medical home") was significantly associated with children having up-to-date (4:3:1) immunizations at 24 months. In multivariate analysis, infants whose parents reported having no medical home were 2.00 (95% CI 1.27, 3.14) times more likely to be missing shots at 24 months of age than were those with a medical home.

CONCLUSIONS(S):
We found a significant association between children having a medical home and up-to-date immunization coverage rates. Further study is needed to explore whether increasing the proportion of children who have a medical home would increase immunization rates

LEARNING OBJECTIVES:
Participants will understand the significance of a medical home and the role it plays in immunization coverage rates.

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