Use of a data-based approach by a health maintenance organization to identify and address physician barriers to pediatric vaccination--California, 1995.
Based on a vaccination coverage assessment during January-May 1994, 44% of 2-year-olds enrolled in the southern California health plan of a national health maintenance organization (HMO) were up-to-date at their second birthday for the complete series of recommended vaccinations (4:3:1:1 series). This coverage level was low compared with the levels for some other health plans in the HMO (range: 39%-85% for the 41 other health plans). The assessment had been recommended by the National Committee for Quality Assurance (a national accreditation body for HMOs) and data had been obtained for analysis from the 1993 Health Plan Employer Data and Information Set (HEDIS), which is a standardized set of health-plan performance measurements including selected preventive services (e.g., mammography, cervical cancer screening, eye examinations for persons with diabetes, cholesterol screening, and pediatric vaccination). To assist the southern California health plan in developing interventions for increasing coverage, in May 1995, the HMO's national research center conducted a study to determine possible causes for the low pediatric vaccination coverage level. This report summarizes the findings of the analysis and illustrates the use of a data-based approach to assist in solving problems related to low vaccination coverage in a managed-care setting.
D002140:California / Q000453:epidemiology; D002675:Child, Preschool; D003628:Database Management Systems; D007722:Health Knowledge, Attitudes, Practice; D006279:Health Maintenance Organizations / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D017589:Immunization Programs; D007193:Independent Practice Associations / Q000592:standards / Q000706:statistics & numerical data*; D007223:Infant; D011320:Primary Health Care / Q000592:standards / Q000706:statistics & numerical data; D011786:Quality Control; D014481:United States; D014611:Vaccination / Q000592:standards / Q000706:statistics & numerical data*