Centralized Reminder/Recall to Increase Immunization Rates in Young Children: How Much Bang for the Buck?
Centralized Reminder/Recall to Increase Immunization Rates in Young Children: How Much Bang for the Buck?
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DOI：
10.1016/j.acap.2016.11.016
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发表时间：
2017-04-01
影响因子：
3.1
通讯作者：
Herlihy, Rachel
中科院分区：
文献类型：
--
作者：
Kempe, Allison;Saville, Alison W.;Herlihy, Rachel
OBJECTIVE: We compared the effectiveness and costeffectiveness of: 1) centralized reminder/recall (C-R/R) using the Colorado Immunization Information System (CIIS) versus practice-based reminder/recall (PB-R/R) approaches to increase immunization rates; 2) different levels of C-R/R intensity; and 3) C-R/R with versus without the name of the child's provider.METHODS: We conducted 3 sequential cluster-randomized trials involving children aged 19 to 25 months in 15 Colorado counties in March 2013 (trial 1), October 2013 (trial 2), and May 2014 (trial 3). In C-R/R counties, the intensity of the intervention decreased sequentially in trials 1 through 3, from 3 to 1 recall messages. In PB-R/R counties, practices were offered training using CIIS and financial support. The percentage of children with up-to-date (UTD) vaccinations was compared 6 months after recall. A mixed-effects model assessed the association between C-R/R versus PB-R/R and UTD rates.RESULTS: C-R/R was more effective in trials 1 to 3 (relative risk =1.11; 95% confidence interval 1.01-1.20; P =.009). Effectiveness did not decrease with decreasing intervention tensity (P =.59). Costs decreased with decreasing intensity in the C-R/R arm, from $18.72 per child brought UTD in trial 1 to $10.11 in trial 3. Costs were higher and more variable in the PB-R/R arm, ranging from $20.63 to $237.81 per child brought UTD. C-R/R was significantly more effective if the child's practice name was included (P
