D. Wood et al., Immunization registries in the United States: Implication for the practiceof public health in a changing health care system, ANN R PUB H, 20, 1999, pp. 231-255
Citations number
81
Categorie Soggetti
Public Health & Health Care Science","Envirnomentale Medicine & Public Health
Although immunization rates among children are rising across the country, r
ates in inner-city areas have remained at similar to 50%-60%, less than or
equal to 30% lower than corresponding suburban or state immunization levels
. The failure to raise immunization levels in poor, underserved populations
is caused in part by the lack of timely and accurate child-specific immuni
zation information for providers and parents. Immunization registries are a
new tool in health care that can be used to address these and other barrie
rs to effective immunization delivery. Moreover, immunization registries ha
ve the potential to help health care officials track and improve delivery f
or a broad range of important child health services. An immunization regist
ry is a computerized database of information on children (usually preschool
-age children) in a defined population (e.g, those enrolled in a health mai
ntenance organization or living in a specific geographic area), which is us
ed to record and track all immunizations received by each child. The regist
ry receives the information primarily from public and private providers tha
t administer immunizations, as well as from parents, schools, and other age
ncies. A fully functioning immunization registry can be used to identify in
dividual children in need of immunizations and to report on immunization ra
tes by population characteristics such as child age, assigned provider, or
geographic area (e.g, neighborhood, city). Today, >250 local public health
departments have immunization registries that are in various stages of plan
ning or development. Only a small number of these registries meet the minim
um functional criteria of maintaining records on 95% of all eligible 2-year
-old children in the target population and providing an electronic immuniza
tion record that is accessible to providers. Nascent immunization registrie
s represent innovative technologic solutions to the challenge of monitoring
health problems and health care access on a population basis. This is a fu
ndamental activity of public health agencies, but one that is increasingly
shared by large health maintenance organizations. The study of the developm
ent of immunization registries across the United States provides an importa
nt case study for how public health agencies will use the rapidly developin
g health information infrastructure to perform health assessment and health
assurance activities in a managed care environment.