title: An analysis of the immunization status of preschool children enrolled in a statewide Medicaid managed care program.
abstract: 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.
authors.affiliation: Department of Pediatrics, Brown University, Providence, Rhode Island, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Vivier
authors.forename: A J
authors.initials: AJ
authors.lastname: Alario
authors.forename: G
authors.initials: G
authors.lastname: Peter
authors.forename: T
authors.initials: T
authors.lastname: Leddy
authors.forename: P
authors.initials: P
authors.lastname: Simon
authors.forename: V
authors.initials: V
authors.lastname: Mor
mesh_terms: 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