title: Personal health record use and association with immunizations and well-child care visits recommendations.
abstract: OBJECTIVE
  To determine the association of parental use of integrated personal health records (PHRs) with children's adherence to immunization and well-child care (WCC) visit recommendations.
  
  
  METHODS
  For the immunization and WCC visit measures, we retrospectively analyzed, respectively, 766 and 639 matched pairs at Kaiser Permanente (KP) Hawaii and 2795 and 2448 pairs at KP Northwest who were ≤ 31 days old at enrollment and continuously enrolled for 2 years between January 2007 and July 2011. The independent variable (≥ 1 PHR feature used vs none) was matched using propensity scores on parental and children characteristics. The dependent variables were 2 measures from the 2010 Healthcare Effectiveness Data and Information Set: combination 2 immunization (all immunizations vs <all) and number of WCC visits through 15 months old (≥ 6 vs <6). We conducted multivariate logistic, propensity score-matched regression adjusting for parents' education and child's continuity of care.
  
  
  RESULTS
  Children whose parents used ≥ 1 PHR feature (vs none) had higher odds of adhering to the recommended immunizations only at KP Northwest (KP Hawaii: OR 1.1, 95% CI 0.8-1.4, P > .05; KP Northwest OR 1.2, 95% CI 1.0-1.3, P < .05). PHR use was associated with better adherence to WCC visit recommendations for both KP Hawaii (OR 1.9, 95% CI 1.3-2.9, P < .001) and KP Northwest (OR 2.5, 95% CI 2.1-2.9, P < .001).
  
  
  CONCLUSIONS
  Young children whose parents used a PHR were more likely to adhere to the recommended WCC visits in both regions but immunizations in only 1 region.
authors.affiliation: Kaiser Permanente Center for Health Research Hawaii, Honolulu, HI. Electronic address: jeffrey.o.tom@kp.org.
authors.forename: Jeffrey O
authors.initials: JO
authors.lastname: Tom
authors.affiliation: Kaiser Permanente Center for Health Research Northwest, Portland, OR.
authors.forename: Chuhe
authors.initials: C
authors.lastname: Chen
authors.affiliation: Kaiser Permanente Northwest, Portland, OR.
authors.forename: Yi Yvonne
authors.initials: YY
authors.lastname: Zhou
mesh_terms: D005260:Female; D006254:Hawaii; D055991:Health Records, Personal; D006297:Health Services Accessibility / Q000592:standards*; D006801:Humans; D007114:Immunization / Q000592:standards / Q000706:statistics & numerical data*; D007231:Infant, Newborn; D008297:Male; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care; D012189:Retrospective Studies
keywords: HEDIS; Healthcare Effectiveness Data and Information Set; ICD-9; International Classification of Disease, 9th revision; KP; Kaiser Permanente; PHR; Personal health record; WCC; Well-child care