This study seeks to better understand the impact of practice-level factors on up-to-date (UTD) rates in children. We compared practice-level vaccination rates for 54 practices to survey data regarding office practices for staffing, vaccine delivery, reminder-recall, and quality improvement. Vaccination rates at 24 and 35 months were analyzed using t tests, analysis of variance, and linear regression. Private practices and those using standing orders had higher UTD rates at 24 months (P =.01; P =.03), but not at 35 months. Having a pediatrician in the office was associated with higher UTD rates at both 24 and 35 months (P <.01). Participating in a network and taking walk-in patients were associated with lower UTD rates (P =.03; P =.03). As the percentage of publicly insured patients decreases, the UTD rate rises at 24 and 35 months (r = '0.43, P =.001; r = '0.037, P =.007). Reported use of reminder recall-systems, night/evening hours, and taking walk-in patients were not associated with increased UTD rates.
- care delivery systems
- childhood vaccines
- office systems
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health