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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Matilde Irigoyen, MD1, Sally Findley, PhD2, Marian D. Chitu, MD3, Shaofu Chen, PhD4, Frank Chimkin, MBA, MSW4, and Robert A. Jenders, MD, MS5. (1) Division of General Pediatrics, Columbia University, 622 W. 168th St., VC4-402, New York, NY 10032, 212-305-6227, mi5@columbia.edu, (2) Joseph L. Mailman School of Public Health, Columbia University, 600 West 168th Street, Fourth floor, New York, NY 10032, (3) Pediatrics, New York Presbyterian Hospital, 622 West 168th Street, 4th Floor, VC-412, New York, NY 10032, (4) Department of Pediatrics, Columbia University, 622 West 168th Street, VC4-402, New York, NY 10032, (5) Medical Informatics, Columbia University, 622 West 168 Street, VC5, New York, NY 10032
Background: Chart audits are the standard methodology for practice coverage assessment. Immunization registries now offer the potential for reliable and timely assessments.
Method: From 1996-2001, we conducted semi-annual assessments at a network of 5 inner-city practices in New York City. In 2000, we launched a private immunization registry at the network and in 2001 we started using the registry to generate practice assessments.
Results: To conduct chart audits we recruited and trained staff on CASA methodology, obtained clinic enrollment listings, generated a random sample of 300/clinic, extracted data from charts into scannable forms, entered, cleaned and verified data (partly automated), analyzed data, and generated reports that required a one-time programming and template creation. The labor associated with these tasks was estimated at 1030 hours for the 5 clinics, per semiannual cycle. For the registry assessment we were able to use the entire patient population. The registry already had automated built-in data cleaning and verification. The statistical analysis and generation of reports were the same as for chart audits. These tasks required 8 hours for the 5 clinics per semiannual cycle. In April 2001, the chart audits and the registry produced similar CASA coverage rates for children <12 months and an 11% rate difference for 12-23 month-olds.
Conclusion: Immunization registries offer the potential for reliable, timely and low-cost practice coverage assessments. The major challenges to registry assessments were implementation costs and availability of historical data. The major benefits included the ability to run real-time assessments on the entire population at a relatively low cost.
Learning Objectives:
Keywords: Immunizations, Assessments
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.