Measuring pediatric immunization status in a managed care organization: agreement between medical charts and parent telephone interviews.

Abstract

Objective: To measure the agreement between pediatric immunization data obtained from medical charts and data provided by parents during telephone interviews and to assess the reliability of immunization information provided during parent telephone interviews.

Design: Medical charts reviews and telephone interviews with parents.

Setting: Prudential HealthCare.

Participants: Children sampled for the 1993 HEDIS study and the parents of those children (n = 356).

Main outcome measure: Overall agreement between immunization data obtained from medical charts and data provided by parents during telephone interviews.

Results: Agreement between immunization data obtained from medical charts and data provided in parent telephone interviews varies from poor to good if the parent refers to a shot record during the interview. Agreement between the two data sources is better with single dose vaccines (i.e., 1 MMR) than multiple dose vaccines (i.e., 4 DTP). Although parents tend to report fewer immunizations than are indicated in the child's medical chart, the medical charts in this study contained too many vaccine omissions to be considered reliable "gold standards" of vaccine receipt. Parents who refer to a shot record when providing information about pediatric immunizations provide reliable data (r = .8807-1.0).

Conclusion: When measuring completion of the immunization series, especially among parents who do not have access to a shot record, medical chart reviews remain the better approach in the managed care setting.