Article2012

Effectiveness and Net Cost of Reminder/Recall for Adolescent Immunizations

Christina A. Suh · Alison W. Saville · Matthew F. Daley · Judith E. Glazner · Jennifer C. Barrow · Shannon K. Stokley +4 more

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Abstract

OBJECTIVE: To assess the effectiveness of reminder/recall (R/R) for immunizing adolescents in private pediatric practices and to describe the associated costs and revenues. METHODS: We conducted a randomized controlled trial in 4 private pediatric practices in metropolitan Denver. In each practice, 400 adolescents aged 11 to 18 years who had not received 1 or more targeted vaccinations (tetanus-diphtheria-acellular pertussis, meningococcal conjugate, or first dose of human papillomavirus vaccine for female patients) were randomly selected and randomized to intervention (2 letters and 2 telephone calls) or control (usual care) groups. Primary outcomes were receipt of >1 targeted vaccines and receipt of all targeted vaccines 6 months postintervention. We calculated net additional revenue for each additional adolescent who received at least 1 targeted vaccine and for those who received all targeted vaccines. RESULTS: Eight hundred adolescents were randomized to the intervention and 800 to the control group. Baseline rates of having already received tetanus-diphtheria-acellular pertussis, meningococcal conjugate, and first dose of human papillomavirus vaccine before R/R ranged from 33% to 54%. Postintervention, the intervention group had significantly higher proportions of receipt of at least 1 targeted vaccine (47.1% vs 34.6%, P < .0001) and receipt of all targeted vaccines (36.2% vs 25.2%, P < .0001) compared with the control group. Three practices had positive net revenues from R/R; 1 showed net losses. CONCLUSIONS: R/R was successful at increasing immunization rates in adolescents and effect sizes were comparable to those in younger children. Practices conducting R/R may benefit financially if they can generate additional well-child care visits and keep supply costs low.

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References

2008Recommendations of the Advisory Committee on Immunization Practices (ACIP)2006ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES 2006Influenza Vaccination of Health-Care Personnel: Recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP)2000Effect of Patient Reminder/Recall Interventions on Immunization Rates 2005Patient reminder and recall systems to improve immunization rates 2011National and state vaccination coverage among adolescents aged 13 through 17 years--United States, 2010.1999A Randomized Study of Tracking With Outreach and Provider Prompting to Improve Immunization Coverage and Primary Care 1986Comparison of three methods of recalling patients for influenza vaccination.

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