title: Influence of Office Systems on Pediatric Vaccination Rates.
abstract: This study seeks to better understand the impact of practice-level factors on up-to-date (UTD) rates in children. We compared practice-level vaccination rates for 54 practices to survey data regarding office practices for staffing, vaccine delivery, reminder-recall, and quality improvement. Vaccination rates at 24 and 35 months were analyzed using t tests, analysis of variance, and linear regression. Private practices and those using standing orders had higher UTD rates at 24 months ( P = .01; P = .03), but not at 35 months. Having a pediatrician in the office was associated with higher UTD rates at both 24 and 35 months ( P < .01). Participating in a network and taking walk-in patients were associated with lower UTD rates ( P = .03; P = .03). As the percentage of publicly insured patients decreases, the UTD rate rises at 24 and 35 months ( r = -0.43, P = .001; r = -0.037, P = .007). Reported use of reminder recall-systems, night/evening hours, and taking walk-in patients were not associated with increased UTD rates.
authors.affiliation: 1 Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Rachael T
authors.initials: RT
authors.lastname: Zweigoron
authors.affiliation: 1 Medical University of South Carolina, Charleston, SC, USA.
authors.forename: James R
authors.initials: JR
authors.lastname: Roberts
authors.affiliation: 2 Chicago Department of Public Health, Chicago, IL, USA.
authors.forename: Marcia
authors.initials: M
authors.lastname: Levin
authors.affiliation: 3 NYU Langone Medical Center and School of Medicine, New York, NY, USA.
authors.forename: Jean
authors.initials: J
authors.lastname: Chia
authors.affiliation: 1 Medical University of South Carolina, Charleston, SC, USA.
authors.forename: Myla
authors.initials: M
authors.lastname: Ebeling
authors.affiliation: 4 Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.|5 Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: Helen J
authors.initials: HJ
authors.lastname: Binns
mesh_terms: D002675:Child, Preschool; D005260:Female; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D008297:Male; D010372:Pediatrics / Q000458:organization & administration* / Q000706:statistics & numerical data*; D010824:Physicians' Offices / Q000458:organization & administration* / Q000706:statistics & numerical data*; D058996:Quality Improvement / Q000706:statistics & numerical data; D017010:Reminder Systems / Q000706:statistics & numerical data
keywords: care delivery systems; childhood vaccines; office systems