Public Provider Immunization Assessments in Indiana
2000 Assessment Results
The public provider immunization assessment continued to focus on the immunization coverage levels of patients aged 24 through 35 months (i.e., two-year old children). To maintain consistency with previous years' assessments, data were collected on children born in 1997 who received immunizations from Indiana's public immunization providers. Limited data is also presented from the 1999 public provider immunization assessment, representing those children born in 1996 who received vaccine from public providers.
Public immunization providers have been sub-divided into two groups: local health departments and non-health department public providers. Non-health department public providers receive publicly funded vaccine, but are not affiliated with a local health department. Because of the many differences between these public provider types, their assessment results have been analyzed separately.
All local health departments (n = 94) in Indiana received an immunization assessment of their 24-35 month old patient population. In order to maintain significant sample sizes, immunization assessments of the non-health department public providers (n = 25) were restricted to those with at least 25 patients in the 24 to 35 month old age range.
Populations were also defined as urban or non-urban for
comparison of immunization coverage levels. Urban counties, as defined by
Indiana State Department of Health standards, include: Allen, Lake, Marion, St.
Joseph, and Vanderburgh. All other counties in Indiana have been classified as
non-urban for purposes of analysis.
Assessments of immunization coverage levels of 24-35 month old patients in 93 of the 94 local health department clinics were completed using the Clinic Assessment Software Application (CASA) designed by the Centers for Disease Control and Prevention (CDC).
An electronic link has been made between CASA and ImTime, the computerized immunization tracking system utilized by 91 or the 94 local health departments. This link allows for an assessment to be performed on the entire population of active patients aged 24-35 months included in a health department's ImTime system, providing an accurate look at their immunization coverage levels and practices. For those health departments not currently using ImTime, standardized procedures were followed to obtain a statistically significant sample of two-year old patients. In this manner, comparable reports for each health department were generated.
The Marion County Health Department (MCHD) utilizes a different electronic database for monitoring immunization records. For this reason, for the 2000 immunization assessment, MCHD provided ISDH with a self-generated summary report of immunization coverage levels for the two-year old patient population found in their database who are assigned to either their local health department or one of the 13 non-health department immunization clinics found in Marion County.
Manual CASA assessments, based on a statistically significant
sample, were also performed for 39 of the 52 non-health department public
providers with at least 25 eligible patients. All thirteen non-health department
public providers in Marion County were assessed using the MCHD electronic
The entire two-year old patient population was assessed for those local health departments with the ImTime/CASA linkage.
For those local health departments and non-health department
public providers where a manual CASA assessment was performed, a statistically
significant sample of their two-year old patient population was assessed. The
sample size for each assessment was based on the number of two-year olds seen by
each public provider and was determined using a built-in feature of the CASA
Results for each provider's CASA assessment were entered into
EpiInfo software for analysis. Use of this software allowed for calculation of
statewide summary statistics.