An analysis of the immunization status of preschool children enrolled in a statewide Medicaid managed care program.
OBJECTIVE
To measure immunization coverage rates for children enrolled in a statewide Medicaid managed care program and determine the impact of sociodemographic characteristics and the type of primary care provider site on immunization coverage.


METHODS
A random sample of 2000 was chosen from children between the ages of 19 and 35 months who had been continuously enrolled in the Medicaid managed care program for 1 year. Sociodemographic data and a list of primary care providers for the study children were obtained from administrative databases. Immunization histories were determined by medical record review.


RESULTS
Vaccine-specific immunization rates for diphtheria-tetanus-pertussis, polio, Haemophilus influenzae type b, hepatitis B, and measles-mumps-rubella ranged from 87% to 94%, with an overall coverage rate of 75%. Overall immunization status varied by primary care provider site as follows: office-based, 72%; community health center, 75%; hospital-based clinic, 79%; and staff model health maintenance organization, 85% (chi(2) test, P =.008).


CONCLUSIONS
Immunization rates compare favorably with national rates for this low-income group. Sociodemographic characteristics were not important predictors of underimmunization, but rates did vary by the type of primary care provider site.
Vivier
P M
PM
Department of Pediatrics, Brown University, Providence, Rhode Island, USA.
Alario
A J
AJ
Peter
G
G
Leddy
T
T
Simon
P
P
Mor
V
V
D002662:Child Health Services / Q000191:economics; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007114:Immunization / Q000191:economics / Q000706:statistics & numerical data*; D008297:Male; D008329:Managed Care Programs; D008484:Medicaid; D012237:Rhode Island; D012959:Socioeconomic Factors