title: National examination of compliance predictors and the immunization status of children: precursor to a developmental model for health systems.
abstract: OBJECTIVE
  The gap between children's immunization requirements and actual compliance is staggering. Using a national survey instrument, the purpose of this study was to analyze the relationship between select predictors and immunization status in children between 19 months and 6 years of age.
  
  
  METHODS
  From the 1998 Medical Expenditure Panel Survey, 1575 children were included in a multivariate logistical model. Outcomes were measured as compliance with approved vaccination regimens.
  
  
  RESULTS
  Only 67% of children between 19 months and 6 years old were compliant with all recommended vaccines. However, nonminority children with health insurance from families with income above the federal poverty line or living outside a metropolitan statistical area were more likely to be vaccinated. Children of older or educated parents likewise tended to have complete immunization.
  
  
  CONCLUSIONS
  Analyzing childhood immunization via parental characteristics identifies prevalent predictors of compliance. Outcomes suggest potential strategies for health systems to focus on children's health issues--specifically immunizations.
authors.affiliation: Department of Defense, Army Medical Department, Darnall Army Community Hospital, Fort Hood, TX 76544, USA.
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Bundt
authors.forename: Hsou-mei
authors.initials: HM
authors.lastname: Hu
mesh_terms: D002675:Child, Preschool; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D007182:Income; D007223:Infant; D007348:Insurance, Health; D016015:Logistic Models; D008962:Models, Theoretical; D010349:Patient Compliance / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors