Literature DB >> 25380614

Improving Immunizations in Children: A Clinical Break-even Analysis.

Kyle Bradford Jones1, Chad Spain2, Hannah Wright3, Lisa H Gren3.   

Abstract

INTRODUCTION: Immunizing the population is a vital public health priority. This article describes a resident-led continuous quality improvement project to improve the immunization rates of children under 3 years of age at two urban family medicine residency clinics in Salt Lake City, Utah, as well as a break-even cost analysis to the clinics for the intervention.
METHODS: Immunization records were distributed to provider-medical assistant teamlets daily for each pediatric patient scheduled in clinic to decrease missed opportunities. An outreach intervention by letter, followed by telephone call reminders, was conducted to reach children under 3 years of age who were behind on recommended immunizations for age (total n=457; those behind on immunizations n=101). Immunization rates were monitored at 3 months following start of intervention. A break-even analysis to the clinics for the outreach intervention was performed.
RESULTS: Immunizations were improved from a baseline of 75.1% (n=133) and 79.6% (n=223) at the two clinics to 92.1% (n=163) and 89.6% (n=251), respectively, at 3 months following the start of intervention (P<0.01). The average revenue per immunization given was $81.57. The financial break-even point required 36 immunizations to be administered.
CONCLUSION: Significant improvement in the immunization rate of patients under 3 years of age at two family medicine residency training clinics was achieved through decreasing missed opportunities for immunization in clinic, and with outreach through letters and follow-up phone calls. The intervention showed positive revenue to both clinics.
© 2015 Marshfield Clinic.

Entities:  

Keywords:  Immunizations; Public health; Quality improvement; Resident education

Mesh:

Year:  2014        PMID: 25380614      PMCID: PMC4504662          DOI: 10.3121/cmr.2014.1234

Source DB:  PubMed          Journal:  Clin Med Res        ISSN: 1539-4182


  19 in total

Review 1.  Effect of patient reminder/recall interventions on immunization rates: A review.

Authors:  P G Szilagyi; C Bordley; J C Vann; A Chelminski; R M Kraus; P A Margolis; L E Rodewald
Journal:  JAMA       Date:  2000-10-11       Impact factor: 56.272

2.  Development, Testing, and Implementation of the ACGME Clinical Learning Environment Review (CLER) Program.

Authors:  Kevin B Weiss; Robin Wagner; Thomas J Nasca
Journal:  J Grad Med Educ       Date:  2012-09

3.  Making residents visible in quality improvement.

Authors:  Carl Patow
Journal:  Acad Med       Date:  2009-12       Impact factor: 6.893

4.  Effectiveness and cost-effectiveness of letters, automated telephone messages, or both for underimmunized children in a health maintenance organization.

Authors:  T A Lieu; A M Capra; J Makol; S B Black; H R Shinefield
Journal:  Pediatrics       Date:  1998-04       Impact factor: 7.124

5.  Contagious diseases in the United States from 1888 to the present.

Authors:  Willem G van Panhuis; John Grefenstette; Su Yon Jung; Nian Shong Chok; Anne Cross; Heather Eng; Bruce Y Lee; Vladimir Zadorozhny; Shawn Brown; Derek Cummings; Donald S Burke
Journal:  N Engl J Med       Date:  2013-11-28       Impact factor: 91.245

6.  Methodological issues in determining rates of childhood immunization in office practice. A study from pediatric research in office settings (PROS).

Authors:  P M Darden; J A Taylor; E J Slora; C M Hasemeier; L Asmussen; J C Recknor; R C Wasserman
Journal:  Arch Pediatr Adolesc Med       Date:  1996-10

7.  Improving pediatric immunization rates: description of a resident-led clinical continuous quality improvement project.

Authors:  Kyle Bradford Jones; Lisa H Gren; Richard Backman
Journal:  Fam Med       Date:  2014-09       Impact factor: 1.756

8.  Economic evaluation of the routine childhood immunization program in the United States, 2009.

Authors:  Fangjun Zhou; Abigail Shefer; Jay Wenger; Mark Messonnier; Li Yan Wang; Adriana Lopez; Matthew Moore; Trudy V Murphy; Margaret Cortese; Lance Rodewald
Journal:  Pediatrics       Date:  2014-03-03       Impact factor: 7.124

9.  Effect of a novel birth intervention and reminder-recall on on-time immunization compliance in high-risk children.

Authors:  Surabhi Vora; Lisa Verber; Sandra Potts; Tynisha Dozier; Robert S Daum
Journal:  Hum Vaccin       Date:  2009-06-28

10.  National, state, and local area vaccination coverage among children aged 19-35 months - United States, 2012.

Authors: 
Journal:  MMWR Morb Mortal Wkly Rep       Date:  2013-09-13       Impact factor: 17.586

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  1 in total

Review 1.  Application of quality improvement approaches in health-care settings to reduce missed opportunities for childhood vaccination: a scoping review.

Authors:  Abdu A Adamu; Olalekan A Uthman; Elvis O Wambiya; Muktar A Gadanya; Charles S Wiysonge
Journal:  Hum Vaccin Immunother       Date:  2019-04-22       Impact factor: 3.452

  1 in total

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