The contribution of missed opportunities to childhood underimmunization in Baltimore.
Pediatrics
; 97(4): 474-80, 1996 Apr.
Article
en En
| MEDLINE
| ID: mdl-8632931
ABSTRACT
OBJECTIVE:
To determine the community-wide incidence of missed opportunities to vaccinate, to describe the clinical settings in which they occur, and to estimate the impact of missed opportunities on immunization coverage. DESIGN ANDMETHODS:
We abstracted outpatient medical records from a random, community-based sample of 2-year-old children whose residence was inner-city Baltimore. The date of each vaccine and the date, diagnoses, and temperature at each visit were collected for 502 children at 98 different provider sites. MAIN OUTCOMEMEASURES:
Missed opportunities to vaccinate and up-to-date vaccination status.RESULTS:
By 24 months of age, 75% of the children had at least one missed opportunity and only 55% were up-to-date for the 431 series. Missed opportunities occurred at more than one third of eligible visits for each vaccine, including > 20% of preventative care visits. Diagnoses commonly associated with missed opportunities were "well child," otitis media, upper respiratory infection, gastroenteritis, skin infection, and resolving illness. If no missed opportunities had occurred, 73% of the children would have been up-to-date by 24 months.CONCLUSIONS:
Missed opportunities occurred commonly at providers serving inner-city children in Baltimore and represent a major factor in underimmunization. Reduction of missed opportunities by accurate screening at all visits and adherence to the contraindication guidelines is a provider-based, low-cost method to increase immunization coverage.
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Banco de datos:
MEDLINE
Asunto principal:
Inmunización
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Child, preschool
/
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Pediatrics
Año:
1996
Tipo del documento:
Article
País de afiliación:
Estados Unidos