BACKGROUND:
As the immunization schedule becomes increasingly complex, reminding parents when immunizations are due and recalling patients when overdue take on increasing importance. However, a computerized immunization tracking system and reminder/recall efforts have not demonstrated significant improvement in UTD rates at Northeast Valley Health Corporation (non-profit community health center in Los Angles County serving a low-income, medically underserved population).

OBJECTIVE:
To improve UTD rates by utilizing case management protocols that will follow-up and track children 0–2 years of age, at each of the NEVHC clinics.

METHOD:
Comprehensive case management strategies to promote and sustain the connection between families and their medical home were implemented at 4 NEVHC clinics. One clinic was designated as the control site. Each month a list of children, not UTD, was generated at designated intervals (3, 5, 7, 13, 20 and 24 months of age). These children were enrolled into the project and followed until they completed the primary series (4-3-1-3-3) or 3 years of age. Protocols included three phone call attempts and a postcard, if necessary.

RESULT:
The average baseline UTD rate for 24–35 month old children at the four NEVHC Clinics was 47% in August 2002. First year results showed the average UTD rate for the four intervention sites increased to 80%. The difference in UTD rates between August 2002 and June 2003 were statistically significant at all five of the clinic sites, including the control site. However, the chi square value for the control site was 8.89. Critical value is p=.025. During the second year, case management was implemented at all five clinics. UTD results for the second year increased to 93%.

CONCLUSION:
Case management strategies demonstrated a significant improvement in UTD rates of children 0–2 years of age.

LEARNING OBJECTIVES:
To describe case management strategies utilized to improve UTD rates of 0–2 year old children.