Abstract
Objective
To assess the impact of a managed care-based patient reminder/recall system on immunization
rates and preventive care visits among low-income adolescents.
Methods
We conducted a randomized controlled trial between December 2009 and December 2010
that assigned adolescents aged 11–17 years to one of three groups: mailed letter,
telephone reminders, or control. Publicly insured youths (n = 4115) were identified
in 37 participating primary care practices. The main outcome measures were immunization
rates for routine vaccines (meningococcus, pertussis, HPV) and preventive visit rates
at study end.
Results
Intervention and control groups were similar at baseline for demographics, immunization
rates, and preventive visits. Among adolescents who were behind at the start, immunization
rates at study end increased by 21% for mailed (P < .01 vs control), 17% for telephone (P < .05), and 13% for control groups. The proportion of adolescents with a preventive
visit (within 12 months) was: mailed (65%; P < .01), telephone (63%; P < .05), and controls (59%). The number needed to treat for an additional fully vaccinated
adolescent was 14 for mailed and 25 for telephone reminders; for an additional preventive
visit, it was 17 and 29. The intervention cost $18.78 (mailed) or $16.68 (phone) per
adolescent per year to deliver. The cost per additional adolescent fully vaccinated
was $463.99 for mailed and $714.98 for telephone; the cost per additional adolescent
receiving a preventive visit was $324.75 and $487.03.
Conclusions
Managed care-based mail or telephone reminder/recall improved adolescent immunizations
and preventive visits, with modest costs and modest impact.
Keywords
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Article Info
Publication History
Published online: March 18, 2013
Accepted:
January 7,
2013
Received:
October 2,
2012
Footnotes
This trial, the Primary Care and Adolescent Immunization for Rochester, is registered at http://clinicaltrials.gov/ as NCT01057888.
The authors have no conflicts of interest to disclose.
Identification
Copyright
© 2013 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
