title: Combination vaccine use and vaccination quality in a managed care population.
abstract: OBJECTIVE
  To evaluate the impact of a pentavalent combination vaccine on childhood immunization coverage rates and timeliness within a managed care organization.
  
  
  METHODS
  Retrospective matched-cohort analysis of encounter data from administrative claims and a state immunization registry.
  
  
  METHODS
  Children were stratified into 2 demographically matched cohorts (combination and reference), based on receipt of the DTaP/HepB/IPV combination vaccine. Children were followed until 24 months of age, and coverage rates and on-time rates were assessed. Outcomes were measured for the HEDIS Combination 2 vaccine series (4 doses of diphtheria/tetanus/pertussis, 3 doses of polio, 1 dose of measles/mumps/rubella, 3 doses of Haemophilus influenzae type b, 3 doses of hepatitis B, and 1 dose of varicella) and each vaccine series individually.
  
  
  RESULTS
  Children in the combination cohort were significantly more likely to be fully vaccinated for the HEDIS Combination 2 series by 2 years of age and to be vaccinated within the recommended age ranges. In the combination cohort 86.9% (752/865) of patients were fully covered compared with only 74.1% (641/865) of the reference cohort (P <.001). In the combination cohort 45.2% (391/865) of patients received vaccinations on time versus 37.5% (324/865) of the reference cohort, P = .001.
  
  
  CONCLUSIONS
  Receipt of DTaP/HepB/IPV was associated with improved coverage and age-appropriate immunization in a managed care population.
authors.affiliation: Xcenda, Palm Harbor, FL 34685, USA. lhappe@xcenda.com
authors.forename: Laura E
authors.initials: LE
authors.lastname: Happe
authors.forename: Orsolya E
authors.initials: OE
authors.lastname: Lunacsek
authors.forename: Gary S
authors.initials: GS
authors.lastname: Marshall
authors.forename: Tamara
authors.initials: T
authors.lastname: Lewis
authors.forename: Shannon
authors.initials: S
authors.lastname: Spencer
mesh_terms: D019433:Chickenpox Vaccine / Q000008:administration & dosage*; D002662:Child Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D002669:Child Welfare / Q000706:statistics & numerical data; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D018073:Haemophilus Vaccines / Q000008:administration & dosage*; D017325:Hepatitis B Vaccines / Q000008:administration & dosage*; D006801:Humans; D017589:Immunization Programs / Q000592:standards* / Q000706:statistics & numerical data; D007115:Immunization Schedule; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration / Q000592:standards*; D022542:Measles-Mumps-Rubella Vaccine / Q000008:administration & dosage*; D019984:Quality Indicators, Health Care; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014611:Vaccination / Q000706:statistics & numerical data*; D017778:Vaccines, Combined / Q000008:administration & dosage*; D018074:Vaccines, Conjugate / Q000008:administration & dosage