Managed care organizations' performance in delivery of adolescent immunizations, HEDIS, 1999-2002.
OBJECTIVE
The Health Plan Employer Data Information Set (HEDIS) provides comparative information across health plans to measure the quality of care and preventive services for health plan beneficiaries. We examined recent trends in adolescent immunizations recommended by the Advisory Committee for Immunization Practices (ACIP) measured through HEDIS and reported to the National Committee for Quality Assurance (NCQA).


METHODS
The study was based on a longitudinal regression analysis of commercial managed care organizations' HEDIS measures from 1999-2002. HEDIS performance measures and plan characteristics include a sample of approximately 100-400 enrollees per plan each year. The outcome measures were the proportions of enrollees aged 13 years sampled in the plan who received measles-mumps-rubella vaccine (MMR), hepatitis B vaccine, and varicella vaccine.


RESULTS
The immunization rates for all three antigens increased significantly from 1999 to 2002 (MMR: 57-68%; hepatitis B: 28-51%; and varicella: 21-38%). Factors in the final multivariable models that were found to be significantly associated with increased proportions immunized with MMR vaccine, hepatitis B vaccine, and varicella vaccine include year of report, presence of school entry laws, years in business up to 25 years, and operating in the northeastern U.S. region; the only factor associated with decreasing immunization rates for all antigens was the number of providers per 100 commercial enrollees.


CONCLUSIONS
Consistent with previous reports, adolescent immunization rates are improving yet remain suboptimal. Strategies to increase immunization rates, as well as to improve documentation of immunization status, among commercial health insurance plans need to be developed and implemented.
Bardenheier
Barbara H
BH
Immunization Services Division, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. BFB7@cdc.gov
Groom
Holly
H
Zhou
Fangjun
F
Kong
Yuan
Y
Shefer
Abigail M
AM
Stokley
Shannon K
SK
Shih
Sarah C
SC
D000293:Adolescent; D016497:Adolescent Health Services / Q000458:organization & administration*; D003140:Communicable Disease Control / Q000458:organization & administration*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D017589:Immunization Programs / Q000458:organization & administration*; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D020380:Needs Assessment; D015397:Program Evaluation; D012042:Registries; D018570:Risk Assessment; D014481:United States