How complete are immunization registries? The Philadelphia story
How complete are immunization registries? The Philadelphia story
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DOI：
10.1016/j.ambp.2005.08.006
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发表时间：
2006-01-01
期刊：
影响因子：
--
通讯作者：
Lutz, JP
中科院分区：
文献类型：
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作者：
Kolasa, MS;Chilkatowsky, AP;Lutz, JP
目的：评估宾夕法尼亚州费城儿童登记数据的准确性和完整性，这些数据由免疫不足风险地区的提供者提供服务。方法：费城公共卫生部从接受政府资助的疫苗接种的30家私人诊所中随机抽取45名19-35个月大的儿童(或所有19-35个月大的儿童，如果诊所中有45名儿童)作为样本，这些诊所位于邮政编码，儿童有免疫不足的风险。比较了图表和登记数据，以确定从登记中失踪的儿童比例，并评估免疫覆盖率的差异。结果：在620名接受调查的儿童中，567名(92%)在注册中心。4种白喉-破伤风-无细胞百日咳疫苗、3种脊髓灰质炎疫苗、1种麻疹-风疹疫苗和3种b型流感嗜血杆菌疫苗接种率在图表(80%覆盖率)和登记表(62%覆盖率)之间有显著差异(P<；.05)。向登记处提交电子医疗记录或直接向登记处转移电子数据的服务提供者在登记处登记的儿童人数和登记处报告的免疫覆盖率比那些从账单记录或日志表格中录入数据的人多得多。所有类型的做法在向登记处转移完整数据方面都遇到了困难。结论：尽管92%的研究儿童在登记中，但当登记数据与图表数据进行比较时，免疫覆盖率明显较低。由于电子病历和直接电子数据传输产生了更完整的登记数据，在将提供者与免疫登记联系起来时，应鼓励使用这些方法。
Objective.-To assess accuracy and completeness of Philadelphia, Pa, registry data among children served by providers in areas at risk for underimmunization. Methods.-Philadelphia's Department of Public Health selected a simple random sample of 45 children age 19-35 months (or all children age 19-35 months if there were < 45 children in the practice) from each of 30 private practices receiving government-funded vaccine and located in zip codes where children are at risk for underimmunization. Chart and registry data were compared with determine the proportion of children missing from the registry and assess differences in immunization coverage. Results.-Of 620 children reviewed, 567 (92%) were in the registry. Significant differences (P < .05) were observed in immunization coverage for 4 diphtheria-tetanus-acellular pertussis vaccinations, 3 polio vaccinations, 1 measles-runlitips-rubella vaccination, and 3 Haemophilus influenzae type b vaccinations between the chart (80% coverage) and registry (62% coverage). Providers submitting electronic medical records or directly transferring electronic data to the registry had significantly more children in the registry and higher registry-reported immunization coverage than those whose data were entered from billing records or log forms. All practice types experienced difficulties in transferring complete data to the registry. Conclusions.-Although 92% of study children were in the registry, immunization coverage was significantly lower when registry data were compared with chart data. Because electronic medical records and direct electronic data transfer resulted in more complete registry data, these methods should be encouraged in linking providers with immunization registries.