title: A comparison of multiple data sources to identify vaccinations for veterans with spinal cord injuries and disorders.
abstract: Monitoring vaccination activity requires regular access to information about patient vaccination status. This report describes our experience using multiple Department of Veterans Affairs (VA) data sources to determine availability and completeness of vaccination information for veterans with spinal cord injuries and disorders (SCI&D). Administrative and clinical databases were limited to coding vaccine administration, undercounted vaccinations, and were unable to account for whether the vaccine was offered and the reasons for nonreceipt. Medical record review provided more detail but was labor intensive and costly. Patient surveys provided the richest information but were costly, time-consuming, and based on a sample of patients. Agreement was poor between data sources. This report suggests that while VA is well positioned to use national databases for clinical care decisions and to inform policy, vaccination data were incomplete. Electronic records must include data that are consistently entered and validated before they can be useful for care management and decision making.
authors.affiliation: Spinal Cord Injury Quality Enhancement Research Initiative, Midwest Center for Health Services and Policy Research, Hines Veterans Administration Hospital, IL 60141, USA. weaver@research.hines.med.va.gov
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
authors.forename: Michael
authors.initials: M
authors.lastname: Hatzakis
authors.forename: Charlesnika T
authors.initials: CT
authors.lastname: Evans
authors.forename: Bridget
authors.initials: B
authors.lastname: Smith
authors.forename: Sherri L
authors.initials: SL
authors.lastname: LaVela
authors.forename: Carolyn
authors.initials: C
authors.lastname: Wallace
authors.forename: Marcia W
authors.initials: MW
authors.lastname: Legro
authors.forename: Barry
authors.initials: B
authors.lastname: Goldstein
mesh_terms: D003625:Data Collection; D016208:Databases, Factual; D006801:Humans; D007252:Influenza Vaccines; D007251:Influenza, Human / Q000209:etiology / Q000517:prevention & control; D008485:Medical Audit; D008498:Medical Record Linkage; D016347:Medical Records Systems, Computerized; D019982:Organizational Case Studies; D022242:Pneumococcal Vaccines; D011018:Pneumonia, Pneumococcal / Q000209:etiology / Q000517:prevention & control; D013119:Spinal Cord Injuries / Q000150:complications; D014481:United States; D014493:United States Department of Veterans Affairs; D014600:Utilization Review; D014611:Vaccination / Q000706:statistics & numerical data*; D014728:Veterans
chemical_list: D007252:Influenza Vaccines; D022242:Pneumococcal Vaccines