COMPUTER REMINDERS IMPROVE ON-TIME IMMUNIZATION RATES

OBJECTIVES. This study examines the effectiveness of computer-generate d telephone reminders in improving infants receiving on-time immunizat ions. A computer called parents at home, reminded them of their child' s visit, and asked if they could keep the appointment. If parents eith er canceled or failed to honor the appointment, the computer called ba ck a few days later and asked them to reschedule. METHODS. A medical a ssistant recruited 124 consecutive mothers to receive automated comput er reminders. These mothers' infants were younger than 6 months, were being seen at an outpatient clinic for a first visit, and were patient s of three attending physicians and three nurse practitioners. These i nfants were compared to 89 infants from the same clinic, in the same a ge range, who were being seen for the first time during the same perio d by the same providers but not contacted by the medical assistant. Su bjects were selected from mothers who brought their infants for their first visit in an outpatient urban clinic that serves predominantly mi nority clients. A research assistant reviewed patients' medical record s and collected the infants' birthday, mothers' age, race, source of p ayments, and the immunization record of the infants. Immunization was considered to be late if, at the time of the first visit, it was more than 30 days past due for any of the recommended immunizations of the American Academy of Pediatrics, except for Hepatitis B vaccine which w as not recommended at the time of the study. The dependent variable wa s on-time immunization. The independent variables were age of the moth er at baseline, age of the child at baseline, and membership in either the comparison or the experimental group. Chi-square tests and logist ic regression were used to analyze the data. RESULTS. The participatio n rate for appointments for the experimental group was 82%, as compare d to a 69% overall participation rate for the clinic providers. The on -time immunization rate for experimental subjects was 67.8%, whereas t he comparison group had an on-time immunization rate of 43.4% (differe nces were significant at alpha levels less than 0.01). CONCLUSIONS. Co mputerized reminders sent to the parents led to an increase in partici pation rate at the clinic and an increase in on-time immunization for their infants.