RISK-FACTORS FOR DELAYED IMMUNIZATION AMONG CHILDREN IN AN HMO
RISK-FACTORS FOR DELAYED IMMUNIZATION AMONG CHILDREN IN AN HMO
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DOI：
10.2105/ajph.84.10.1621
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发表时间：
1994-10-01
影响因子：
12.7
通讯作者：
ADLER, NE
中科院分区：
文献类型：
--
作者：
LIEU, TA;BLACK, SB;ADLER, NE
目标。改善儿童免疫接种的及时提供已成为国家的当务之急。本研究的目的是在经济状况良好的预防保健患者中确定延迟免疫的非财务预测因素。这项前瞻性队列研究使用电话访谈和计算机免疫跟踪系统来评估一个地区性团体模式健康维护组织中13个月大的儿童(n=530)。超过三分之一的受访家长不知道下一次免疫是什么时候。13%的婴儿在15个月大时推荐的麻疹-腮腺炎-风疹疫苗接种迟到了90天或更长时间。多子女(OR=1.4，P<0.01)、没有正规医生(OR=2.9，P<0.05)、不知道什么时候接种(OR=2.0，P<0.01)、不担心接种风险(OR=1.4，P<0.05)是延迟免疫的独立预测因素。仅有经济来源并不能保证儿童及时接种疫苗。在有管理的卡尔环境中，可能会覆盖医疗改革下越来越多的儿童，需要进行干预，以更好地告知父母何时应该接种疫苗。
Objectives. Improving the timely delivery of childhood immunizations has become a national imperative. This study aimed to identify nonfinancial predictors of delayed immunization among patients with good financial access to preventive care.Methods. This prospective cohort study used telephone interviews and a computerized immunization tracking system to evaluate 13-month-old children (n = 530) in a regional group-model health maintenance organization.Results. More than one third of parents interviewed did not know when the next immunization was due. Thirteen percent were late for the measles-mumps-rubella immunization, recommended at 15 months of age, by 90 days or more. Independent predictors of delayed immunization included having a larger number of children (odds ratio [OR] = 1.4, P < .01), not having a regular doctor (OR = 2.9, P < .05), not knowing when the shot was due (OR = 2.0, P < .01), and not worrying about the risks of shots (OR = 1.4, P < .05).Conclusions. Financial access alone does not guarantee timely childhood immunization. In managed carl settings, which may cover increasing numbers of children under health care reform, interventions are needed to better inform parents of when immunizations are due.